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mycobacterial infections Flashcards

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1
Q

greek term for consumption/wasting

A

Pthisis

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2
Q

wasting disease, vampirism

A

TB

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3
Q

TB (who)

A

Robert Koch

obligate aerobe
15-20 hrs doubling time
acid-fastness

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4
Q

stain: TB

A

Ziehl Nielssen (bright red)

non-motile
weakly gram (+)
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5
Q

responsible for acid fastness

A

mycolic acid

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6
Q

glycolipid molecule responsible for pathogenicity of TB

A

cord factor

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7
Q

found in the cell walls of mycobacteria that interlock to form an asymmetrical bilayer

A

Lipoarabinomannan (LAM)

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8
Q

inhibit macrophage activation

A

Lipoarabinomannan (LAM)

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9
Q

Microbial stains

A
  1. acid fast bacili stain
    a. Ziehl Nielssen
    b. Kinyoun/Cold method
  2. Flourochrome stain (Auramine-Rhodamine stain)
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10
Q

most sensitive and reliable stain and easier to read

A

fluorochrome stain

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11
Q

causes TB

A

M. tuberculosis

M.bovis (intestinal TB)

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12
Q

TB tx length

A

6-9months

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13
Q

diseases that predispose TB infection

A 
diabetes mellitus
hogkins lymphoma
chronic lung disease
chronic renal failure
malnutrition
alcoholism
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14
Q

malignancy of hematopoietic system

A

hodgkins lymphoma

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15
Q

Dx of TB

A

skin test (mantoux test/tuberculin test) purified protein derivatives peaks in 48-72hours

delayed type hypersensitivity reaction
only a screening not not absolute dx

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16
Q

Categories/pathophysiologic types

A
  1. primary TB
  2. Secondary TB
  3. Miliary TB
  4. Progressive Pulmonary TB
  5. Other forms: endobranchial, endotracheal, large TB; systemic miliary TB; isolated TB; lymphadenitis; MDR-TB
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17
Q

most commonly affect the lungs

occurs in unexposed unsensitized px

A

Primary TB

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18
Q

nonspecific or pneumonia-like then disappears

A

primary TB

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19
Q

nodules in the lungs where bacteria hide in macrophages

A

ghon focus

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20
Q

where does the infection drain into? (primary TB)

A

hilar lymph nodes (can be infected)

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21
Q

center of Ghon focus udnergoes ___ necrosis

A

caseous necrosis

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22
Q

parenchymal lung lesion + nodal involvement

A

Ghon complex

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23
Q

radiologically detectable calcification of ghon complex

A

ranke complex

Ghon complex -> progressive fibrosis -> ranke complex

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24
Q

primary TB in childen

A

primary complex

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25
3 essential elements for Dx TB
``` epitheloid macrophages (granuloma) langhans type giant cells caseation necrosis ```
26
hallmark of healing
granulation tissue
27
latent infection reactivates highly infectious state
secondary TB
28
2 weeks cough + intermittent fever cavitary lesions at the apex of the lungs bloody cough
secondary TB
29
millet seeds bec they cause lesions in small blood vessels (TB)
Miliary TB
30
occurs when organisms draining through lymphatics enter venous blood and circulate back to the lungs
Miliary TB
31
progressive pulmonary TB + miliary TB
tuberculous emphysema
32
T/F miliary TB affects at least 5 major organs
F miliary TB affects at least 3 major organs (brain, lungs, liver, ovaries, omentum, nostril, larynx etc)
33
TB: older adults and immunocompromised people
progressive pulmonary TB
34
apical lesion exands into the adjacent lung and eventually erodes into bronchi and vessels which evacuate the caseous center --> irregular cavity
progressive pulmonary TB
35
TB: lesions expand and coalesce resulting in consolidation of large regions or even whole lobes of the lungs
miliary TB
36
hemoptysis
coughing up of blood due to erosion of BV
37
``` isolated TB meninges kidneys adrenals bone fallopian tube vertebrae ```
meninges: tuberculous meningitis kidneys: renal TB adrenals: Addison disease bone: osteomyelitis fallopian tube: salpingitis vertebrae: Pott's disease
38
criteria for MDR-TB
must be resistant to at least rifampicin and isoniazid
39
TB identification
sputum acid-fast bacillus testing molecular testing PCR identification QuantiFERON
40
gold standard in TB indentification
sputum acid-fast bacillus testing
41
simple blood test that aids in detection of M. tuberculosis >95% sensitivity highest specificity results are obtained after 2 hours
QuantiFERON
42
Hansen disease
Leprosy
43
affects skin and peripheral nerves resulting in disabling deformities
leprosy/hansen disease
44
cultured in what animal (leprosy)
armadillo (core temp 32-34)
45
types (leprosy)
tuberculoid leprosy | lepromatous leprosy
46
T/F leprosy has high communicability and endemic among people living
F low communicability and yes endemic
47
less severe form of leprosy dominated by neuronal involvement hyperpigmented margins and depressed pale ceters (central healing)
tuberculoid leprosy
48
dry scaly skin lesions (asymmetric) that lack sensation
tubercucloid leprosy / paucibacillary leprosy
49
granulomatous lesions closely resembling TB and bacilli are almost NEVER found
TB leprosy / paucibacillary leprosy
50
more severe form of leprosy
lepromatous leprosy
51
leprosy: symmetric skin lesions
lepromatous leprosy involves skin, peripheral nerves, anterior chamber of eye, upper airways down to larynx, testes, hands, feet (cold areas)
52
lesions contain large aggregates of lipid-laden macrophages filled with masses of acid-fast bacilli
lepromatous leprosy multibacillary leprosy
53
unresponsiveness of the host immune system
anergic leprosy /lepromatous leprosy
54
tests for leprosy
lepromin test | skin punch biopsy
55
lepromin test procedure
performed by injecting a small sample of inactivated m.leprae under your skin (usually forearm) --> small lump --> examined 3 days after --> if no reaction, wait 28 days again
56
lepromin test positive test
redness, swelling and other skin changes indicate the presence of tuberculoid and borderline TB leprosy no skin reaction: may be lepromatous leprosy
57
considered the primary technique to obtain diagnostic, full-thickness skin specimens
skin punch biopsy
58
performed using a circular blade or TREPHINE attached to a pencil-like handle
skin punch biopsy rotated down through the epidermis and derpmis and into the subcutaneous fat
59
responsible for the loss of farm animals (bovines) during the first half of 18th century
mycobacterium bovis
60
mycobacterium bovis: route
ingestion but may also spread through aerosol droplets
61
mycobacterium bovis: human infection | why is it rare?
pasteurization process kills bacteria in the milk
62
abudant acid-fast bacilli within macrophages target the mononuclear-phagocyte system granulomas and tissue destrustion are rare
mycobacterium avian-intracellulare complex

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