The BCG vaccine is derived from what mycobacterium?
Bovis
What type of hypersensitivity reaction does TB cause?
IV
What is the agar used to culture Mycobacterium TB?
Lowenstein-Jensen agar
When is the usual presentation of IFN-gamma deficiency?
BCG vaccine causes disseminated TB
What are the three cells that Mycobacterium leprae survives in
Skin cells
Macrophages
Schwann cells
What disease is caused by Mycobacterium leprae?
Leprosy
What is the difference between Mycobacterium leprosy and tuberculoid leprosy?
Tuberculoid is Th1 cell mediated, and has few organisms in lesions
Lepromatous leprosy is a Th2 cell mediated response, that causes lesions with a large amount of bacteria in the lesions
What animal is suspected as a source of leprosy?
Armadillos
Can we culture Mycobacterium leprae?
M. leprae cannot be cultured.
Which of the RESPIRE medications is the only one
that can be used as a solo medication in prophylaxis of
TB?
INH (isoniazid) is the only TB medication that can be used as a solo
medication in prophylaxis of the exposed individuals or asymptomatic
positive-PPD responders.
Rifampin is used as a combination drug because of rapid plasmid-mediated resistance formation. What is the only solo indication for its use?
The only instance when Rifampin is used as a solo medication is for the
prophylaxis of meningitis in patients with unidentified etiology or children that have been exposed to H. influenzae type B patients
What is the MOA and use of Clofazimine?
Binds to and damages DNA
Anti-leprosy
What are ghon complexes?
TB granulomas on the lung, found on CXR
What is the basis of the PPD test?
Macrophages present mycolic acid on MHC II to Th1, releasing Il-2 to resting lymphocytes to activate CD8 T cells
True or false: most of the time, the body effectively controls TB infections via B cell mediated immunity
False–T cell mediated immunity
Where in the body do lesions from Mycobacterium leprae usually appear? WHy?
Hands and distal extremities d/t predilection for cold areas
True or false: the DTH test with lepromatous leprosy is negative
True
What are the DOCs for lepromatous leprosy?
Dapsone
Rifampin
What happens to the neurons with Mycobacterium leprae infx?
loss of distal neurons cause a loss of sensation
Which has lion like lesions: lepromatous or tuberculoid?
Lepromatous
What are the skin lesions of Tuberculoid leprosy?
Small tubercles that do not have active organisms
What are the skin lesions of Lepromatous leprosy?
large, lion like reaction that have tons ‘o bacteria in the lesions
How contagious is lepromatous leprosy?
Not very
What is the bacteria that does not have a cell wall
Mycobacterium pneumoniae
What is the disease caused by Mycobacterium pneumoniae?
Atypical pneumonia
Who is Mycobacterium pneumonia common in?
Young adults (5-20 yo)
Cold agglutinins = ?
Agglutination of the RBCs with cold (IgM mediated
Warm agglutinins?
Agglutination of the RBCs in warmth (IgG mediated)
What type of agglutinins does Mycobacterium pneumoniae cause?
Cold
What is the treatment for Mycobacterium pneumoniae?
Erythromycin
What are the diseases that cause cold agglutination?
Mycobacterium pneumoniae
CMV
HIV
What are the diseases that cause warm agglutination?
Brucellosis
Rickettsia
Salmonella
What are the drugs that cause warm agglutinins?
Methyldopa
PCN
Quinidine
Monospot heterophile = ?
EBV
s/sx of mono with a negative monospot = ?
CMV
What are the bacteria that have a positive Weil-Felix rxn?
RMSF
What is the quellung test used for?
Strep pneumonia
What does the VDRL / RPR test assess for? What autoimmune disease is this positive in?
Syphilis
SLE
ASO titers are for what?
Rheumatic fever
Treponema pallidum has cross reactivity with what?
Cardiolipin
What is the microscopy method that can help visualize Treponema pallidum?
Darkfield
What are the s/sx of primary, secondary, and tertiary syphilis?
1 = Chancres
2. Maculopapular rash on palms and soles
3 = Gummas, aorta, CNS
What is the treatment for syphilis?
PCN
Titier of baby is less than the mother for RPR = ?
IgG is from the mother, and the fetus is not infected
What are gummas?
Granulomas to Treponema pallidum
What is the confirmatory serology for syphilis?
FTA-ABS
What is the Jarisch-Herxheimer rxn?
a reaction to endotoxin-like products released by the death of harmful microorganisms within the body during antibiotic treatment (usually syphilis). Resembles sepsis s/sx
What are condyloma latum?
a cutaneous condition characterized by wart-like lesions on the genitals. They are generally symptoms of the secondary phase of syphilis, caused by the spirochete, Treponema pallidum.
How long does it take for form primary, secondary and tertiary
“Sex” weeks for each step except tertiary***
At what point is syphilis VDRL negative? What do you need to test then?
Tertiary
CSF
What are the other infection diseases that can cause a false positive VDRL?
EBV
Viral hepatitis
Tree barking of the aorta = ?
Tertiary syphilis
What is the confirmatory test for syphilis?
FTA-ABS
If a VDRL/RPR and FTA ABs test are all positive what does this indicate?
ACtive infx
If VDRL/RPR tests are all positive, but FTA ABs is negative, what does this indicate?
Successful treatment
What may cause false negative of VDRL/RPR and FTA ABS?
AIDS or other immunosuppressants