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Bacteriology > Mycobacterium > Flashcards

Mycobacterium Flashcards

1
Q

Morphology of Mycobacterium spp.

A

Slender, slightly curved or straight, rod-shaped (bacilli)

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2
Q

Are Mycobacterium spp. motile?

A

No

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3
Q

Aerotolerance of Mycobacterium spp.

A

Strict or Obligate aerobes (some are Capnophiles)

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4
Q

Mycobacterium spp. are known to be ______ bacteria.

A

acid-fast

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5
Q

Mycobacterium spp. exhibits which color when stained using Acid Fast method?

A

Red

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6
Q

Incubation period of Mycobacterium spp.

A

2 months or 8 weeks

For slow growers, some species can mature faster (rapid growers)

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7
Q

Mycobacterium spp. are ____ growers.

A

slow

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8
Q

Which Mycobacterium spp. are rapid growers?

A

Group IV Runyon Classification (Rapid Growers)
* Mycobacterium fortuitum
* Mycobacterium chelonae
* Mycobacterium phlei
* Mycobacterium smegmatis

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9
Q

Cell wall components of Mycobacterium spp.

A

High amounts of Lipids and Mycolic acid

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10
Q

Do Mycobacterium spp. resist decolorization in Acid Fast Staining?

A

Yes

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11
Q

____ that act as storage deposits of nutrients exist in Mycobacterium spp.

A

Inclusion bodies

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12
Q

What are inclusion bodies?

A

Storage deposits

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13
Q

Which inclusion body is present in Mycobacterium spp.?

A

Much granules

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14
Q

Mycobacterium is classified into how many groups?

A

3

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15
Q

Mycobacterium spp. are classified into different groups based on ________.

A

Their capability to cause infection

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16
Q

Groups under Mycobacterium spp.

A
  1. Mycobacterium tuberculosis complex
  2. Mycobacteria other than tuberculosis (MOTT) or Non-tuberculosis mycobacteria (NTM)
  3. Mycobacterium leprae
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17
Q

Members of Mycobacterium tuberculosis complex

A

ACRONYM: TBA
* Mycobacterium tuberculosis
* Mycobacterium bovis
* Mycobacterium africanum

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18
Q

What do members of M. tuberculosis complex have in common?

A

They are all causative agents of Tuberculosis

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19
Q

Members under this group are the most common causes of Tuberculosis

A

M. tuberculosis complex

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20
Q

Mycobacterium tuberculosis is also known as ________.

A

Koch Bacillus

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21
Q

“Koch Bacillus”

A

Mycobacterium tuberculosis

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22
Q

Mycobacterium tuberculosis was discovered by ______.

A

Robert Koch

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23
Q

Robert Koch was the one who discovered ______.

A

Mycobacterium tuberculosis

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24
Q

Mycobacterium tuberculosis was discovered in _____.

A

1882

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25
Q

Mycobacterium tuberculosis requires ____ for growth.

A

5 - 10% CO2

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26
Q

Virulence factors of Mycobacterium tuberculosis

A
  • Cord Factor
  • Sulfatides
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27
Q

How are cord factor and sulfatides virulent?

A

They produce a sticky response which is responsible for making the mucus very purulent which may trap the bacteria inside, masking it and making it unrecognized by phagocytes

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28
Q

Skin test for Mycobacterium tuberculosis

A

PPD or Mantoux Test or Tuberculin

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29
Q

Skin test for Mycobacterium tuberculosis is measured after _____.

A

48 hours

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30
Q

(+) Result of skin test for Mycobacterium tuberculosis

A

> 10 mm

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31
Q

To determine whether the quality of the specimen is to be accepted or rejected, we will use the ________.

A

Bartlett’s Classification

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32
Q

Bartlett’s classification is used to ______.

A

qualify the specimen

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33
Q

Which objective lens is used when viewing epithelial cells?

A

Low Power Objective (LPO)

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34
Q

LPO is used when viewing ______.

A

Epithelial cells

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35
Q

Which objective lens is used when viewing polymorphonuclear cells?

A

High Power Obejctive (HPO)

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36
Q

HPO is used when viewing ______.

A

Polymorphonuclear cells (PMNs)

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37
Q

Determine which specimen is present

> 10 EC with <25 PMNs

A

Saliva

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38
Q

Determine which specimen is present

<10 EC and >25 PMNs

A

Sputum

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39
Q

Accept or Reject?

> 10 EC with <25 PMNs

A

Reject

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40
Q

Accept or Reject?

< 10 EC and >25 PMNs

A

Accept

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41
Q

Most common specimen for Mycobacterium tuberculosis identification

A

Sputum

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42
Q

Describe the sputum of a patient suspected with Tuberculosis

A

Sticky and very purulent

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43
Q

How many sputum specimens are needed for Direct Microscopic Examination or AFB Identification?

A

3 specimens (1 per day consecutively)

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44
Q

How many sputum specimens are needed for Culture?

A

1 only

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45
Q

Interpret the Scenario

The patient submitted a sputum specimen for 3 consecutive days. Out of all three, 2 specimens turned out to be positive.

A

The patient is definitive for Pulmonary tuberculosis

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46
Q

Interpret the Scenario

The patient submitted a sputum specimen for 3 consecutive days. Out of all three, only 1 specimen turned out to be positive.

A

Request for a 4th specimen

(+) = Definitive of Pulmonary Tuberculosis

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47
Q

Interpret the Scenario

A patient whose sputum was submitted for testing has 1 out of 3 specimens positive for Tuberculosis. After submitting a 4th specimen, it also turned out to be positive.

A

The patient is definitive for Pulmonary tuberculosis

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48
Q

Interpret the Scenario

The patient submitted a sputum specimen for 3 consecutive days. The 4th specimen submitted was negative.

A

Request for repetition of the entire process

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49
Q

Specimens of Tuberculosis

A
  • Sputum
  • Secretions
  • Blood
  • Urine
  • CSF
  • Pleural, Pericardial, and Peritoneal fluid
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50
Q

How are specimens collected if a patient is not able to exudate his/her own sputum?

A

Their secretions are collected through bronchoscopy

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51
Q

Presence of tuberculosis in the CSF is indicated by ______.

A

Pellicle of web-like clot

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52
Q

Presence of tuberculosis in the ____ is indicated by a pellicle of web-like clot.

A

CSF

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53
Q

Presence of tuberculosis in PPP fluid is indicated by ______.

A

Increased Adenosine Deaminase (ADA)

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54
Q

Presence of tuberculosis in ____ is indicated by increased Adenosine Deaminase (ADA).

A

Pleural, Pericardial, and Peritoneal Fluid

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55
Q

DOTS stands for ______.

A

Directly Observed Treatment Short-course

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56
Q

According to DOTS, how many days are sputum sample collected?

A

2 days

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57
Q

How many sputum specimens per patient are collected by DOTS?

A

3

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58
Q

How many sputum specimens are collected in the 1st day according to DOTS?

A

2

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59
Q

How many sputum specimens are collected in the 2nd day according to DOTS?

A

1

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60
Q

When is the first specimen collected according to DOTS?

A

First thing in the morning after the patient’s mouth is washed

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61
Q

When is the second specimen collected according to DOTS?

A

Upon arrival in the laboratory

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62
Q

When is the third specimen collected according to DOTS?

A

First thing in the morning after the patient’s mouth is washed

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63
Q

Prior to culture, the sputum sample must be _________.

A

Digested, decontaminated, and liquefied

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64
Q

The removal of normal flora and contaminating organisms

A

Decontamination

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65
Q

Decontamination means ______.

A

The removal of normal flora and contaminating organisms

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66
Q

The breaking of sulfide bonds in the mucus of Mycobacterium tuberculosis

A

Digestion

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67
Q

Digestion means _______.

A

The breaking of sulfide bonds in the mucus of Mycobacterium tuberculosis

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68
Q

Digestant and Decontaminating agents

A
  • 2-4% NaOH
  • Benzalkonium Chloride (Zephiran)
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69
Q

A liquefying agent that speeds up the digestion process

A

N-acetyl-L-cysteine (NALC)

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70
Q

What is the purpose of NALC in terms of digestion?

A

A liquefying agent that speeds up the digestion process

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71
Q

The most common combination for digesting and decontaminating Mycobacterium spp. causing tuberculosis

A

NALC or Dithiothreitol + 2 - 4% NaOH

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72
Q

Which is substituted for NALC?

A

Dithiothreitol

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73
Q

A digestant-decontaminant that shortens exposure time

A

Benzalkonium Chloride (Zephiran)

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74
Q

What is the purpose of Benzalkonium Chloride (Zephiran) in digestion-decontamination?

A

It is a digestant-decontaminant that shortens exposure time

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75
Q

It liquefies sputum but requires longer time of exposure

A

Trisodium Phosphate

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76
Q

What is the purpose of Trisodium Phosphate in digestion-decontamination?

A

It liquefies sputum but requires longer time of exposure

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77
Q

Another combination for digestion-decontamination

A

Benzalkonium Chloride (Zephiran) + Trisodum Phosphate

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78
Q

It decontaminates specimens contaminated with Pseudomonas aeruginosa

A

5 - 6% Oxalic acid

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79
Q

What is the purpose of 5 - 6% Oxalic acid in digestion-decontamination?

A

It decontaminates specimens contaminated with Pseudomonas aeruginosa

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80
Q

Gram stain of Mycobacterium tuberculosis

A

Gram ghost or none (gram positive)

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81
Q

Stains for Mycobacterium tuberculosis

A
  • Acid Fast Stain
  • Fite Faraco’s Stain
  • Auramine-Rhodamine Fluorochrome Stain
  • Spengler’s Stain
  • Pappenheim’s Stain
  • Baumgarten’s Stain
82
Q

AFB smear size

A

2 cm x 3 cm

83
Q

It uses hematoxylin instead of methylene blue as a counterstain

A

Fite Faraco’s Stain

84
Q

What is the difference between Fite Faraco’s and Acid Fast Stain?

A

Fite Faraco’s uses hematoxylin instead of methylene blue (in AFS) as counterstain

85
Q

Appearance of Mycobacterium tuberculosis using Auramine-Rhodamine Stain

A

Bright, yellowish-orange against a dark background

86
Q

Which kind of microscope is used for Auramine-Rhodamine Stains?

A

Fluorescent microscope

87
Q

A stain used by color blind individuals

A

Spengler’s Stain

88
Q

Appearance of Mycobacterium tuberculosis using Spengler’s Stain

A

Black

89
Q

Appearance of Mycobacterium tuberculosis using Pappenheim’s Stain

A

Red

90
Q

Appearance of Mycobacterium smegmatis using Pappenheim’s Stain

A

Blue

91
Q

Which species appears blue using Pappenheim’s Stain?

A

Mycobacterium smegmatis

92
Q

Appearance of Mycobacterium tuberculosis using Baumgarten’s Stain

A

Blue

93
Q

Appearance of Mycobacterium leprae using Baumgarten’s Stain

A

Red

94
Q

Which species appears red using Baumgarten’s Stain?

A

Mycobacterium leprae

95
Q

Requirement of Mycobacterium tuberculosis for Culture

A

Increased amount of protein

96
Q

Colonial appearance of Mycobacterium tuberculosis

A
  • Tan to buff colonies
  • Dry, warty, rough, and granular
  • Resembles cauliflower
97
Q

Mycobacterium tuberculosis resembles ________.

A

Cauliflower

98
Q

Which form of media is Mycobacterium tuberculosis cultured?

A

Tubed Media

99
Q

Why is Mycobacterium tuberculosis cultured in tubes?

A
  • Moisture does not easily evaporate
  • Small opening = less chance of contaminats and transmission
100
Q

Primary drugs for Mycobacterium tuberculosis

A

ACRONYM: RIPES
* Rifampicin
* Isoniazid
* Pyrazinamide
* Ethambutol
* Streptomycin

101
Q

Secondary drugs for Mycobacterium tuberculosis

A

ACRONYM: CROCKER
* Capreomycin
* Rifabutin
* Ofloxacin
* Ciprofloxacin
* Kanamycin
* Ethionamide
* Rifabutin (ulit hehe)

102
Q

Agar-based Media for Mycobacterium tubereculosis

A
  • Duboi’s Oleic Acid Albumin Medium
  • Mitchinson’s Medium
  • Middlebrook 7H10-7H11
103
Q

Which medium is used for AST in Mycobacterium tuberculosis?

A

Middlebrook 7H10-7H11

104
Q

Egg-based Media for Mycobacterium tubereculosis

A
  • Petragnani Medium
  • Lowenstein-Jensen Medium
  • American Thoracic Society
  • Dorset Egg Medium
105
Q

Liquid Media for Mycobacterium tubereculosis

A
  • Bactec 12B
  • Septi-Check
  • Middlebrook 7H9
106
Q

Inhibitor present in egg-based media for Mycobacterium tubereculosis

A

Malachite green

107
Q

A medium used for heavily contaminated specimen (with increased concentration of malachite green)

A

Petragnani Medium

108
Q

Ma’am Christy’s medium of choice for Mycobacterium tubereculosis

A

Lowenstein-Jensen Medium

109
Q

Niacin Test Principle

A

Niacin + Niacin Ribonucleotide + Aniline Dye + Cyanogen Bromide

110
Q

(+) Result for Niacin Test

A

Yellow color

111
Q

Which organism is (+) for Niacin Test?

A

Mycobacterium tuberculosis

112
Q

(-) Result for Niacin Test

A

No color change

113
Q

Which organism is (-) for Niacin Test?

A

Mycobacterium bovis

114
Q

Catalase Test at 68 C Principle

A

Tween 80 + Mycobacteria + 30% H2O2 + Heat at 68 C (20 mins)

115
Q

Medium for Catalase Test

A

Tween 80

116
Q

Reagent for Catalase Test

A

30% H2O2

117
Q

(+) Result for Catalase Test

A

45 mm height of gas bubbles

118
Q

Which organism is (+) for Catalase Test?

A

Mycobacterium kansasii

119
Q

(-) Result for Catalase Test

A

No bubbles

120
Q

Which organism is (-) for Catalase Test?

A

Mycobacterium tuberculosis

121
Q

Nitrate Reduction Test Principle

A

HCL + Sulfanilamide + n-napthtylethylene diamine

122
Q

(+) Result for Nitrate Reduction Test

A

Pink or Red color

123
Q

Which organism is (+) for Nitrate Reduction Test?

A
  • Mycobacterium kansasii
  • Mycobacterium szulgai
  • Mycobacterium fortuitum
  • Mycobacterium tuberculosis
124
Q

(-) Result for Nitrate Reduction Test

A

No color change

125
Q

Which organism is (-) for Nitrate Reduction Test?

A

Mycobacterium intracellulare

126
Q

(+) Result for Tween 80 HOH Test

A

Red color

127
Q

Which organism is (+) for Tween 80 HOH Test?

A

Mycobacterium kansasii

128
Q

(-) Result for Tween 80 HOH Test

A

No red or amber color

129
Q

Which organism is (-) for Tween 80 HOH Test?

A

Mycobacterium avium

130
Q

(+) Result for Tellurite Reduction Test

A

Smooth, fine, black precipitate

131
Q

Which organism is (+) for Tellurite Reduction Test?

A

Mycobacterium avium

132
Q

(-) Result for Tellurite Reduction Test

A

Gray clumps

133
Q

Which organism is (-) for Tellurite Reduction Test?

A

Mycobacterium kansasii

134
Q

What test is conducted for rapid growers?

A

Aryl Sulfatase Test

135
Q

Aryl Sulfatase Test Principle

A

Tripotassium phenolphthalein disulfide or sulfate is acted upon by aryl sulfatase to produce free phenolphthalein

136
Q

(+) Result for Aryl Sulfatase Test

A

Pink or Red color

137
Q

Which organism is (+) for Aryl Sulfatase Test?

A

Group IV Rounyon Classification: Rapid Growers
* M. fortuitum
* M. chelonae
* M. phlei
* M. smegmatis

138
Q

Which organism is (+) or Susceptible for TCH Susceptibility Test?

A

Mycobacterium bovis

139
Q

Which organism is (-) or Resistant for TCH Susceptibility Test?

A

Mycobacterium tuberculosis

140
Q

TCH stands for ______.

A

Thiophene-2-Carboxylic Acid-Hydrazide

141
Q

Iron Uptake Test Principle

A

To convert ferric ammonium citrate to iron oxide

142
Q

(+) Result for Iron Uptake Test

A

Rusty brown colonies

143
Q

Which organism is (+) for Iron Uptake Test?

A

Rapid growers

144
Q

(-) Result for Iron Uptake Test

A

No color formation

145
Q

Which organism is (-) for Iron Uptake Test?

A

Mycobacterium chelonae

146
Q

Pyrazinamidase Test Principle

A

Pyrazinamidase hydrolyzes pyrazinamide to produce pyrazinoic acid and ammonia in 4 days

147
Q

(+) Result for Pyrazinamidase Test

A

Red pigment

148
Q

Which organism is (+) for Pyrazinamidase Test?

A
  • Mycobacterium tuberculosis
  • Mycobacterium marinum
149
Q

(-) Result for Pyrazinamidase Test

A

No color formation

150
Q

Which organism is (-) for Pyrazinamidase Test?

A
  • Mycobacterium bovis
  • Mycobacterium kansasii
151
Q

Urease Test Principle

A

Detection of urease activity

152
Q

Which organism is (+) for Urease Test?

A

Mycobacterium scrofulaceum

153
Q

Which organism is (-) for Urease Test?

A

Mycobacterium gordonae

154
Q

Sodium Chloride Tolerance Test Principle

A

High salt concentration (5% NaCl) in egg-based media inhibits the growth of most Mycobacteria

155
Q

(+) Result for Sodium Chloride Tolerance Test

A

Growth

156
Q

Which organism is (+) for Sodium Chloride Tolerance Test?

A
  • M. flavescens
  • M. trivìale
  • Most rapid growers
157
Q

Group 1 Runyon’s Classification

A

Photochromogens: KMSA
* M. kansasii
* M. marinum
* M. simiae
* M. asiaticum

158
Q

Group 1 Runyon’s Classification is ____ with the presence of light.

A

pigmented

159
Q

Group 1 Runyon’s Classification is ____ without the presence of light.

A

non-pigmented

160
Q

Which Organism is It?

  • “Yellow Bacillus”
  • Has beta-carotene
  • Nitrate (+)
A

Mycobacterium kansasii

Group 1: Photochromogens

161
Q

M. kansasii is also called as _____.

A

Yellow bacillus

162
Q

Why is M. kansasii termed as “yellow bacillus”?

A

Because it has beta carotene

163
Q

Which Organism is It?

Swimming pool granuloma

A

Mycobacterium marinum

Group 1: Photochromogens

164
Q

M. marinum is associated with ______.

A

Swimming Pool Granuloma

165
Q

Which Organism is It?

Niacin (-)

A
  • Mycobacterium simiae
  • Mycobacterium asiaticum

Group 1: Photochromogens

166
Q

Group 2 Runyon’s Classification

A

Scotochromogens
* M. scrofulaceum (scrofula)
* M. szulgai
* M. xenopi
* M. gordonae
* M. flavescens
* M. thermoresistable

167
Q

Group 2 Rounyon’s Classification is ____ with the presence of light.

A

pigmented

168
Q

Group 2 Rounyon’s Classification is ____ without the presence of light.

A

pigmented

169
Q

Which Organism is It?

  • Cervical lymph adenitis
  • Nitrate (-)
  • Niacin (+)
A

Mycobacterium scrofulaceum

Group 2: Scotochromogens

170
Q

Mycobacterium scrofulaceum is associated with _________.

A

cervical lymph adenitis

171
Q

Which Organism is It?

  • “Tap water Bacillus”
  • Tween 80 (+)
A

Mycobacterium gordonae

Group 2: Scotochromogens

172
Q

Mycobacterium gordonae is also known as _____.

A

Tap water Bacillus

173
Q

Group 3 Runyon’s Classification

A

Non-photochromogens
* M. avium-intracellulare complex
* M. avium
* M. ulcerans
* M. xenopi
* M. triviale
* M. haemophilum
* M. terrae
* M. malmoense
* M. gastri

174
Q

Group 3 Rounyon’s Classification is ____ with the presence of light.

A

non-pigmented

175
Q

Group 3 Rounyon’s Classification is ____ without the presence of light.

A

non-pigmented

176
Q

Which Organism is It?

  • “Battey Bacillus”
  • Tuberculosis in AIDS patients
A

Mycobacterium avium-intracellulare complex

Group 3: Non-photochromogens

177
Q

M. avium-intracellulare complex is also known as _______.

A

Battey Bacillus

178
Q

Which Organism is It?

Tuberculosis in birds and chickens

A

Mycobacterium avium

Group 3: Non-photochromogens

179
Q

Which Organism is It?

  • “Innert Bacillus”
  • Buruli ulcers in skin
A

Mycobacterium ulcerans

Group 3: Non-photochromogens

180
Q

M. ulcerans is also known as _______.

A

Innert Bacillus

181
Q

Which Organism is It?

Hot, cold water taps at 42 C

A

Mycobacterium xenopi

Group 3: Non-photochromogens

182
Q

Which Organism is It?

“Radish Bacillus”

A

Mycobacterium terrae

Group 3: Non-photochromogens

183
Q

Which Organism is It?

“J Bacillus”

A

Mycobacterium gastri

Group 3: Non-photochromogens

184
Q

Group 4 Runyon’s Classification

A

Rapid Growers
* M. fortuitum
* M. chelonae
* M. phlei
* M. smegmatis

185
Q

Which Organism is It?

Grows on MAC without crystal violet

A
  • Mycobacterium fortuitum
  • Mycobacterium chelonae

Group 4: Rapid Growers

186
Q

Which Organism is It?

Provides CO2

A

Mycobacterium phlei

Group 4: Rapid Growers

187
Q

Which Organism is It?

Confused with Mtb in urine

A

Mycobacterium smegmatis

Group 4: Rapid Growers

188
Q

The causative agent of Hansen’s Disease or Leprosy

A

Mycobacterium leprae

189
Q

Mycobacterium leprae is the causative agent of ______.

A

Hansen’s Disease or Leprosy

190
Q

Leprosy is formally known as ____.

A

Hansen’s Disease

191
Q

The appearance of Mycobacterium leprae is described to be as ______.

A

Cigarette packet or Picket-fence

192
Q

Specimen for Mycobacterium leprae

A

Earlobe or Nasal scraping

193
Q

Culture for Mycobacterium leprae

A

Armadillo pads

194
Q

Stain for Mycobacterium leprae

A

Fite-Faraco

195
Q

Treatment for Mycobacterium leprae

A
  • Dapsone
  • Sulfone
196
Q

Skin test for Mycobacterium leprae

A

Lepromin Test

197
Q

Early reaction

A

Fernandez

198
Q

24-48 hours

A

Fernandez or Early reaction

199
Q

Late reaction

A

Mitsuda

200
Q

3-4 weeks

A

Mitsuda or Late reaction

Bacteriology (17 decks)

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