Nelson Ch. 215 Flashcards Preview

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Flashcards in Nelson Ch. 215 Deck (52)
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1

Specialized culture medium for M. tuberculosis

Lowenstein-Jensen

2

Lowenstein-Jensen: Carbon source

Glycerol

3

Lowenstein-Jensen: Nitrogen source

Ammonium salts

4

Hallmark of all mycobacteria

Acid fastness

5

Capacity to form stable mycolate complexes with aryl methane dyes and resist decoloration with ethanol and hydrochloric acids

Acid fastness

6

Hallmark of latent Tb

Reactive tuberculin test and absence of clinical and radiographic manifestations

7

Primary complex or Ghon complex is the combination of

1) Parenchymal pulmonary lesion 2) Lymph node site

8

PTb that occurs >1 year after the primary infection, usually caused by endogenous REGROWTH of bacilli persisting in partially encapsulated lesions

Reactivation Tb

9

MC form of reactivation Tb

Infiltrate or cavity in the apex of the upper lobes, where O2 tension and blood flow are great

10

MC result of female genital tract Tb

Infertility

11

Reason why congenital Tb is rare

Because MC result of female genital tract Tb is infertility

12

MC infectious route of neonatal Tb infection

POSTNATAL airborne transmission from adult with infectious PTb

13

Conditions that adversely affect ___ immunity predispose to progression from Tb infection to disease

Cell-mediated

14

TST is what type of hypersensitivity

Delayed type or Type IV

15

Approximately ___% of infants who receive a BCG vaccine never develop a reactive TST

50

16

Usually, reactivity to TST of infants who receive a BCG vaccine wanes in ___ years

2-3

17

Most crucial risk factor for development of tuberculosis in children

Possible exposure to an adult with or at high risk for infectious PTb

18

Preferred test in determining patient's T cell response to specific M. tb antigens in cases where specificity is important as in patients who received a BCG vaccination

IFN-γ release assays

19

Hallmark of primary PTb

Relatively large size of regional lymphadenitis compared with relatively small size of the initial lung focus

20

Sequence of primary PTb lesion

Hilar lymphadenopathy > focal hyperinflation > atelectasis (collapse-consolidation) or segmental tuberculosis

21

The presence of calcification implies that a Tb lesion has been present for at least ___

6-12 months

22

MC symptoms of pulmonary tuberculosis

Nonproductive cough, mild dyspnea, and CLADs

23

Reactivation Tb or Chronic PTb is uncommon in this age group

Healed Tb infection acquired less than 2 years

24

Reactivation Tb or Chronic PTb is more common in those who acquire the initial infection > ___ years of age

7

25

MC pulmonary sites of reactivation Tb

1) Original parenchymal focus 2) Lymph nodes 3) Apical seedings

26

Apical seedings of Tb established during the hematogenous phase of the early infection

Simon foci

27

MC radiographic presentations of reactivation Tb

Extensive infiltrates or thick-walled cavities in the upper lobes

28

Pleural fluid findings in tuberculous pleurisy (6)

1) Yellow 2) SG 1.012-1.025 3) Protein 2-4 g/dL 4) Glucose low to normal (20-40 mg/dL) 5) Hundreds to thousands of WBCs per mm3 with early predominance of PMNs followed by a high percentage of lymphocytes 6) AFB RARELY POSITIVE

29

MC form of cardiac Tb

Tb pericarditis

30

Most clinically significant form of disseminated Tb

Miliary Tb