Lung dz: TB and Chlamydia Flashcards Preview

Clin Med 1 Test 3 > Lung dz: TB and Chlamydia > Flashcards

Flashcards in Lung dz: TB and Chlamydia Deck (28):
1

three body foci of localized Mycobacterium Avium complex (MAC) inf

lungs, lymphnodes, SSTI's

2

what is a requirement of disseminated version of Myco avium complex inf

HIV with CD4 counts less than 50

3

how is MAC diagnosed

culture

4

how to treat disseminated MAC (2 drug tx a MUST)

Clarithro and ethembutol (with or without rifambutin)

5

when can prophylactic tx (macrolide) of MAC be discontinued in HIV pt's

when CD4 count exceeds 100 for 3 months

6

what type of inf is typical of immunocompromised with pre-existing lung dz

pulmonary MAC

7

tx for pulmonary MAC inf (3)

rifampin + ethembutol + streptomycin (3-5 times/ week x 18-24 months)

8

which condition would show cavitary lesions with patchy infiltrates on x-ray

pulmonary MAC or progressive primary TB

9

how many of those with latent TB inf reactivate (usually from immune impairment)

ten percent of those with latent, and only 5 percent will subsequently get progressive primary TB

10

how should culture be obtained for TB

3 consecutive mornings, or bronchial washings, then wait up to 12 weeks to grow

11

where is node enlargement in TB (as seen in x-ray)

next to mediastinum - hilar and paratracheal areas

12

where are TB lesions in x-ray

small infiltrates throughout, leading to mediastinal, cavitation, and PE later in dz

13

Ghon and Ranke complexes describe what radiologic finding

healed calcified primary TB infections

14

how long after exposure before TB inf shows a positive skin test

2-10 weeks (test doesn't discriminate between latent and active)

15

Positive TB test for immunosuppresed people or those with fibrotic lung xrays

greater than or equal to 5 mm

16

Positive TB test for people with high risk for acquiring TB

greater or equal to 10 mm

17

Postive TB test for people at low risk for TB

greater or equal to 15 mm

18

who is at risk for a false negative Mantoux PPD skin test reading (3)

immunologic disorders, concurrent infection, malnutrition, steroid tx, CKD

19

What lung dz is contracted from birds

Psittacosis - Chlamydia psittaci

20

what are 3 symptoms of Psittacosis

headache, dry cough, myalgia (fever)

21

How does x-ray appear for Psittacosis

"fluffy" diffuse infiltrates

22

describe fever and pulse in Psittacosis

fever up, pulse down

23

how is Psittacosis confirmed

complement fixation (2 weeks post-inf)

24

DOC for Psittacosis

tetracycline (oral or IV q6h x 14-21 days)

25

alternative tx for Psittacosis

azithromycin

26

DOC for C pneumoniae (2)

erythromycin or doxycycline

27

alternative DOC for C pneumoniae (2)

levo or moxy

28

What is the prevalence of C pneumoniae

10 percent of all CAP's