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Pulmonology 2 > Mycobacterial Infections > Flashcards

Flashcards in Mycobacterial Infections Deck (24):
1

What are the rapid growing mycobacteria?

M fortuitum
M chelonae
M absessus

2

What are the slow growing mycobacteria?

M kansaii
M marinum
M avium complex
-M Avium
-M intracellulare

3

What is a common sourse of Non-TB pulm infections?

Water sources
inhalation of aerosols from natural water source or from a heating system

MAC, M kansii, M absessus

4

In what population does progressive lung disease occur

Pts with underlying bronchiectaisis or COPD

5

What are the 2 clinically seen forms of MAC?

.

6

What is the typical imaging finding in Non-TB Myco Infections

Interstitial infiltrates with rare cavitation and involvement of >3 lobes

7

How is Non-TB Myco Infection confirmed?

Clinical H and P
Bacterologic confirmation
-2 pos cultures
BAL sample
Lung or tissue biopsy positive AFB smears
Pos culture from pleural fluid or non pulm site

8

What Abtx are used for Mycobacterium infections

Clarithromycin OR azithromycin
AND Rifampin
AND Ethambutol
12-18 mon
Macrolides

9

What is the cause of Pott's Disease?

Bone infiltration with Mycobactrium

10

What part of the world is TB most common?

Sub saharan africa
India
Southeast Asia
Indonesia

11

What are the 3 possible consequences of inhalation of droplet nuclei?

Organism cleared 70%

Primary TB with active disease 5%
Latent infection with possibility of reactivation. 5%

Very small number have late progression as a result of latent TB

12

What is the finding in initial infection that is not conrolled by local defenses?

Ghon Complex seen on X-ray: Unilateral lymphadenopathy

Hematogenous dissemination if CMI not adequate. Active disease and contageous

13

What are the S and S of Primary TB?

Fever and pulmonary symptoms
chest pain
hilar adenopathy, perihilar infiltrates, effusion

14

How is latent TB diagnosed?

Evidence of a cell mediated immune response.
Positive TB skin test
Interferon Gamma release assay (Quantiferon Gold)

15

How is the Tuberculin Skin test read?

mm of induration
NOT erythema perpendicular to the long axis of the forearm

16

Under what circumstance would a TB skin test be negative when they ARE infected?

Immunosupressed
Cancer Tx
Alcoholism
Anything that would supress the Cell mediated immunity

17

What diagnostic test for TB would you use if you know someone has recieved the BCG vaccine?

Quanterferon Gold

18

What is the LBTI Treatment for TB?

Isoniazid 300mg daily for 9mon

19

What are the risk factors for Tuberculosis?

Silicosis
Diabetes
Chronic Renal Failure
Gastrectomy, jejunoileal bypass
Weight Loss >10% ideal body wt
Children

20

What are the symptoms of TB?

Diurnal Fever becoming more marked as disease progresses
Fever and NS
Grad Cough Prog. with devt of sputum production
Gross Hemoptysis
Dyspnia
Pleuritic Pain
Anorexia, wasting(consumption

21

What are general principles of TB Tx?

Always use at least 2 drugs
Appropriate drug doses
Take drug regularly
Adequate duration of therapy

22

What is included in the 4 drug treatment for TB?

INH, ethambutol, rifampin, pyrazinamide
Daily for 8wks OR
Daily 2wks then 2x week
3x week for 6wks
DOT recommended for schedules that dont require daily dosing

23

What defines Drug resistant TB?

Lab confirmed resistance to INH and RIF

24

What is used to DIAGNOSE TB?

Positive Sputum Culture