TB

Question 1

How many people are infected with TB worldwide

Answer 1

2 billion

Question 2

How many new cases of TB are there annually

Answer 2

8.6 million

Question 3

How many of the new annual cases are in HIV positive patients

Answer 3

1.1 million (75% in Africa)

Question 4

How many of the new annual cases are in children

Answer 4

530,000

Question 5

How many deaths occur annually due to TB

Answer 5

1.3 million

Question 6

How many of the annual deaths are in HIV positive patients

Answer 6

0.3 million

Question 7

How many of the annual deaths are in children

Answer 7

74,000

Question 8

How many TB cases in the UK are in London

Answer 8

39%

45 cases per 100,000

Question 9

How many TB cases in the UK are in the West Midlands

Answer 9

11%

20 cases per 100,000

Question 10

What is the responsible organism for TB

Answer 10

Mycobacteria

Question 11

Where is mycobacteria ubiquitous

Answer 11

Soil

Water

Question 12

Name two of the main TB causing organisms

Answer 12

Mycobacterium Tuberculosis

Mycobacterium Bovis

Question 13

Is Mycobacterium Bovis still an issue

Answer 13

No

It has been eradicated through the pasteurisation of milk

Question 14

In how many UK isolations is Mycobacteria other than tuberculosis (MOTT) found

Answer 14

30%

Question 15

When does MOTT tend to be an issue

Answer 15

In patients with an underlying lung condition

Question 16

Name 4 organisms that are classed under MOTT

Answer 16

Mycobacterium avium-intracellulare (HIV)
M. kansasii
M. malmoense
M. xenopii

Question 17

What bacteria causes leprosy

Answer 17

Mycobacterium Leprae

Question 18

What is mycobacteria

Answer 18

A curved non-motile bacillus

Very slow growing

Question 19

How long is TB treatment

Answer 19

6 months

Question 20

How can mycobacteria grow

Answer 20

Aerobically

This is why it favours the apices of the lungs

Question 21

State 4 properties of mycobacteria

Answer 21

Very thick cell wall
Lipids
Peptidoglycans
Arabinomannans

Question 22

What is mycobacteria resistant to

Answer 22

Acids, alkalis and detergents

Neutrophil and macrophage destruction

Question 23

What type of dyes can complex with mycobacteria cell wall

Answer 23

Aniline based dyes such as carbol fuschin

Question 24

What other type of staining can be used on mycobactera

Answer 24

Acid and alcohol fast bacilli (Ziehl Neilson stain)

Question 25

What is open pulmonary TB

Answer 25

Cavity in the upper lobe of the lung

Question 26

Which mycobacterium causes 'open’ pulmonary TB, coughing and sneezing

Answer 26

Mycobacterium Tuberculosis

Question 27

What do the respiratory droplets of M. tuberculosis contian

Answer 27

Droplet nuclei containing mycobacteria

Question 28

How many nuclei are expelled from one cough

Answer 28

3,500

Question 29

How long do droplets remain airborne for

Answer 29

Very long periods

Question 30

What can eliminate mycobacteria

Answer 30

UV radiation | Infinite dilution

Question 31

What do the larger droplet nuclei impact on

Answer 31

Large airways | They can be cleared

Question 32

How big are the small droplet nuclei

Answer 32

Under 5 micrometers

Question 33

What do the small droplet nuclei have

Answer 33

1-3 organisms which can impact the alveoli and slowly proliferate

Question 34

Where can mycobacterium bovis be consumed from

Answer 34

Infected cow's milk

Question 35

Where is mycobacterium bovis deposited

Answer 35

Cervical and intestinal lymph nodes

Question 36

How to macrophages in the alveoli become activated

Answer 36

Th1 cells

Question 37

What can the activated macrophage kill

Answer 37

Bacterium but causes tissue damage at the same time

Question 38

What do activated macrophages transform into

Answer 38

Epithelioid cells and then transform into Langhan’s giant cells.

Question 39

What is a granuloma

Answer 39

Accumulation of macrophages, epithelioid and Langhan’s cells

Question 40

What is an identifying factor of TB

Answer 40

Central caseating necrosis

Question 41

What 2 things does the Th1 cell mediated immunological response cause

Answer 41

Eliminates/reduces the number of invading mycobacteria | Tissue destruction due to the activation of macrophages

Question 42

Why must the outcome of infection be very finely balanced

Answer 42

As any tip of the scale can cause active disease

Question 43

What factors can affect susceptibility

Answer 43

``` Genetics Race Nutrition Age Immunosuppression ```

Question 44

What factors can affect infecion

Answer 44

Virulence | Number