M5 PART 8 Flashcards by CHESKA CIANNELLE FRANCISCO

Q

They are rod-shaped, aerobic bacteria that do not form spores.
Produce ghost cells using gram staining, cannot be visualize in gram staining
The Ziehl-Neelsen technique of staining is used for identification of acid-fast bacteria.
Weakly acid-fast

A

MYOBACTERIA

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Q

MYOBACTERIA

staining used

A

ZIEHL-NEELSEN

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Q

MYOBACTERIA

oxygen requirement

A

AEROBIC

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Q

MYOBACTERIA

shape

A

rod-shaped

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Q

what makes MYOBACTERIA unique

A

its cell wall has mycolic acid

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Q

MYCOBACTERIUM TUBERCULOSIS

also known as

A

TUBERCLE BACILLI
(KOCH’S BACILLUS)

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Q

MYCOBACTERIUM TUBERCULOSIS

oxygen requirement

A

obligate aerobe

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Q

MYCOBACTERIUM TUBERCULOSIS

generation time

A

18 hours

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Q

MYCOBACTERIUM TUBERCULOSIS

culture media:
for large inoculum

A

semi-synthetic agar
Middlebrook 7H10 & 7H11

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Q

MYCOBACTERIUM TUBERCULOSIS

culture media:
for small inoculum

A

broth media
Middlebrook 7H9 & 7H12

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Q

MYCOBACTERIUM TUBERCULOSIS

culture media:
inspissated egg media

A

Lowenstein-Jensen w/ malachite green

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Q

MYCOBACTERIUM TUBERCULOSIS

has protein component which serves as a source of nutrient of Tubercle bacilli

A

LOWENSTEIN-JENSEN

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Q

Constituents of Tubercle Bacilli

mycolic acids, waxes, and phosphatides

A

LIPIDS

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Q

Constituents of Tubercle Bacilli

obsrved only in virulent strains of Mycobacteria

nonvirulent/avirulent does not have this

A

CORD FACTOR
(serpentine cords)

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Q

Constituents of Tubercle Bacilli

Cord factor is also known as

A

serpentine cords

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Q

Constituents of Tubercle Bacilli

used for tuberculin skin test to exhibit delayed hypersensitivity reaction, exhibit type 4 hypersensitivity reaction

A

PURIFIED PROTEIN DERIVATIVES (PPD)

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Q

Mycobacterium tuberculosis / Tubercle Bacilli

has how many principal lesions

A

2

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Q

Mycobacterium tuberculosis | PATHOLOGY

acute inflammation with edema
Initial site of infection: Lungs
Tuberculin test positive
Seen in the lungs where it may resemble bacterial pneumonia
May heal, result on its own, or lead to necrosis of the tissue that is infected
May lead to proliferative type

A

EXUDATIVE LESION

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Q

Mycobacterium tuberculosis | PATHOLOGY

EXUDATIVE LESION:
initial site of infection

A

LUNGS

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Q

Mycobacterium tuberculosis | PATHOLOGY

EXUDATIVE LESION:
seen in the lungs where it may resemble ____

A

BACTERIAL PNEUMONIA

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Q

Mycobacterium tuberculosis | PATHOLOGY

there is chronic granuloma consist of a central area of giant cells (Langhans’ giant cells) containing tubercle bacilli

A

PRODUCTIVE (PROLIFERATIVE) TYPE

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Q

Mycobacterium tuberculosis | PATHOLOGY

An acute exudative lesion develops and rapidly spreads to the lymphatics and regional lymph nodes.
The lymph node undergoes massive caseation, which usually calcifies (Ghon lesion).
The tuberculin test result becomes positive.

A

PRIMARY INFECTION

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Q

Mycobacterium tuberculosis | PATHOLOGY

It is caused by tubercle bacilli that have survived in a primary lesion.
Characterized by chronic tissue lesions, formation of tubercles, caseation, and fibrosis
Not all tubercle bacilli infection led to primary TB or an active type
If the primary infection heals without causing a disease, the TB may establish a latent infection (inactive).
90% of the patients exposed to mycobacterium tuberculosis would only develop latent infection.
10% may lead to an active type of tuberculosis

A

REACTIVATION TYPE

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Q

Mycobacterium tuberculosis | PATHOLOGY

If the primary infection heals without causing a disease, the TB may establish a ____ infection

A

LATENT

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# **Mycobacterium tuberculosis | PATHOLOGY** ____% of the patients exposed to mycobacterium tuberculosis would only develop **latent infection**

90%

# **Mycobacterium tuberculosis | PATHOLOGY** ____% may lead to an **active type** of tuberculosis

10%

# **Mycobacterium tuberculosis | CLINICAL FINDINGS** * **most common form** * main findings – **cough** and **hemoptysis** (**blood in the sputum**)

PULMONARY TUBERCULOSIS

# **Mycobacterium tuberculosis | CLINICAL FINDINGS** * **mycobacterial cervical lymphadenitis** (swollen and non-tender lymph nodes) * **most common extrapulmonary** manifestation of tuberculosis

SCROFULA

# **Mycobacterium tuberculosis | CLINICAL FINDINGS** **multiple disseminated lesions** due to bacteria resembling "**millet seeds**"

MILIARY TUBERCULOSIS

# **Mycobacterium tuberculosis** * consists of an intradermal injection of one tenth of a milliliter (ml) of PPD tuberculin * used for detecting **history** only * **not used as a diagnostic tool**

TUBERCULIN SKIN TEST

# **Mycobacterium tuberculosis** **Tuberculin skin test** is also known as

MANTOUX SKIN TEST

# **Mycobacterium tuberculosis | TREATMENT** **FIRST-LINE** drugs

**R**ifampin **I**sonizaid **P**yrazinamide **E**thambutol | RIPE

# **Mycobacterium tuberculosis | TREATMENT** **duration** of treatment

6 months

# **Mycobacterium tuberculosis | TREATMENT** patient is already **non-infectious** after ____ of treatment

2-3 weeks

# **Mycobacterium tuberculosis | TREATMENT** drugs given for the **first 2 months**

RIPE

# **Mycobacterium tuberculosis | TREATMENT** drugs given for the **4 remaining months**

Rifampin Isoniazid

# **Mycobacterium tuberculosis | TREATMENT** given to those **resistant** to **first line** drugs

multi-drug resistant

# **Mycobacterium tuberculosis | TREATMENT** given to those **resistant** to **first** & **second line** of drugs

extensively drug resistant

# **Mycobacterium tuberculosis | TREATMENT** * vaccine for tuberculosis * given at **birth** * **more effective to be given at birth** than in adults * **first vaccine to be given at birth**

BACILLE CALMETTE-GUERIN BCG

# **Mycobacterium tuberculosis | TREATMENT** **MO** used in the **preparation** of **BCG vaccine**

Mycobacterium bovis

# **Mycobacterium tuberculosis | TREATMENT** meaning of **DOTS**

directly-observed therapy, short-course

# **MYCOBACTERIUM LEPRAE** growth time

14 days

# **MYCOBACTERIUM LEPRAE** optimal temperature for growth

30C

# **MYCOBACTERIUM LEPRAE** transmission

contact w/ px w/ leprosy

# **MYCOBACTERIUM LEPRAE** disease

Leprosy

# **MYCOBACTERIUM LEPRAE** **Leprosy** is also known as

Hansen's disease

# **MYCOBACTERIUM LEPRAE** Leprosy is **discovered** by

Gerhard Hansen

* **Slowest**-growing human pathogens – **14 days** * **Optimal temperature for growth is 30°C** – grows preferentially in the **skin** and in the **nerves** * **Cannot** be grown in the laboratory in vitro

MYCOBACTERIUM LEPRAE

# **MYCOBACTERIUM LEPRAE** can be grown in

foot pads of mice or armadillos

# **TWO MAJOR TYPES OF LEPROSY** * **Progressive** and **malignant** * **Multiple nodular skin lesions** occur, resulting in the **typical leonine (lionlike) facies** → e**rythema nodosum leprosum (ENL)**

LEPROMATOUS LEPROSY

# **TWO MAJOR TYPES OF LEPROSY** * **Nonprogressive** and **benign** * **Hypopigmented** macular or **plaque-like** skin lesions, thickened superficial nerves, and significant anesthesia of the skin lesions

TUBERCULOID LEPROSY

# **TWO MAJOR TYPES OF LEPROSY** **Lepromatous leprosy** is also known as

**Multi**bacillary leprosy

# **TWO MAJOR TYPES OF LEPROSY** **Tuberculoid leprosy** is also known as

**Pauci**bacillary leprosy

# **MYCOBACTERIUM LEPRAE | PATHOGENESIS** The organism **replicates** ____, typically within skin histiocytes, endothelial cells, and the **Schwann cells of nerves**.

INTRACELLULARLY

# **MYCOBACTERIUM LEPRAE | PATHOGENESIS** The ____ in leprosy is the result of two processes: * Damage from **direct contact** with the bacterium * Damage caused by **CMI attack** on the nerves

NERVE DAMAGE

# **Lepromatous Leprosy** **Cell-mediated response** to M. leprae

REDUCED OR ABSENT

# **Lepromatous Leprosy** Number of **acid-fast** bacilli

MANY

# **Lepromatous Leprosy** Likelihood of **transmitting** leprosy

HIGH

# **Lepromatous Leprosy** Lepromin skin test

NEGATIVE

# **Tuberculoid Leprosy** Lepromin skin test

POSITIVE

# **Tuberculoid Leprosy** Likelihood of **transmitting** leprosy

LOW

# **Tuberculoid Leprosy** Number of **acid-fast** bacilli

FEW

# **Tuberculoid Leprosy** **Cell-mediated response** to M. leprae

PRESENT

# **MYCOBACTERIUM LEPRAE | TREATMENT** DRUG OF CHOICE

DAPSONE

# **MYCOBACTERIUM TUBERCULOSIS** **only** drug in the **1st line** that can be used as treatment **other than tuberculosis**

RIFAMPIN