Resp Exam 3 Flashcards

Question

**_Nocardia_** lab tests

Answer 1

**_No card game for old men_** gram (**+**) **Filamentous** bacilli Catalase (**+**) Urease (**+**) Obligate **Aerobe** (vs. anaerobe for actinomyces) **Mycolic Acids stain** light **_acid fast_** on **_carbofusion_ stain** **_DOES NOT_** form **spores** (but found in **_soil_**)

Answer 2

**_No card game for old men_** **Increased risks** for... * **_CGD patients_** (Chronic Granulomatous Disease) have **increased risk** from **catalase (+)** organisms. * **_Immunocompromised_** are especially vulnerable. * **_Men_** \> Women

Answer 3

**_No card game for old men_** **_3 parts_** 1. **_Pulmonary_: Pneumonia like** symptoms, **_Cavitating_** in the **lungs**) 2. **_CNS_:** Due to **systemic spread** from lungs. **_Brain abscess_ formation**. 3. **_Cutaneous_:** **Indurated** (_hardened_) **lessions** and **_inflammatory_ reaction**

Answer 4

**_No card game for old men_** Sulfonamides

Answer 5

**_Paranormal Mixer_** **_NEG**_ sense _****S**_S **_R_**NA** **_Enveloped_ non**-segmented virus Anti-measles **antibodies** in the **CSF** (**SSPE** from Measles) or **Warthin–Finkeldey** **cells** in **lymph**oid tissue (for **_Measles/Rubeola_**) **_Syncytia_** (cells merged together from **_RSV_**) **_Steeple_** radiographic sign on **xray** (for **_Parainfluenza_**)

Answer 6

**_Paranormal Mixer_** **\*\*\* Respiratory droplet** transmission! **\*\*\*** * **Measles** (Rubeola) AKA **1st** disease * **Mumps** * **Respiratory Syncytial Virus** (RSV) * **Parainfluenza**

Answer 7

**_Paranormal Mixer_** * **_Measles_ (Rubeola):** **HA** **&** **Fusion** (_no NA_) * **_Mumps_: HA, NA, & Fusion** * **_Respiratory Syncytial Virus_ (RSV):** **Fusion** (_only_) * **_Parainfluenza_:** **HA, NA, & Fusion**

Answer 8

**_Paranormal Mixer_** * **Prodromal (early) symptoms (_4 C's!!!_)**: include ****_C_**ough**, ****_C_**onjunctivitis**, ****_K_**oplic signs** (_blue spots_ on red near molars on _bucal mucosa_), ****_C_**oryza** (runny/stuffy nose) * **Fever** of 104º F (40º C) * **1-2 days later**, after Koplic spots, a **late maculopapular rash** **_starts_ on** **_head_** and **works down** (like rubella), but is a **_confluence_ rash** (vs. rubella which does not coalesce) * **Complications** including viral or bacterial **pneumonia**

Answer 9

**_Paranormal Mixer_** ****_S_**ubacute **_s_**clerosing **_p_**an**_e_**ncephalitis** (**SSPE**) AKA **_Dawson_ disease** * Rare and chronic form of **progressive brain inflammation** * **1-15 years** **after** initial Measles (Rubeola) **infection** * Symptoms include **personality changes**, **seizures**, **myoclonus**, **ataxia**, **coma**, and possibly **death**. * **_Buzzwords_:** **"Measles as a child"** or **"Immigrants"**

Answer 10

**_Paranormal Mixer_** 1. **_Hemagglutinin_ (HA):** causes **RBC** to **stick** together 2. **_Fusion proteins_:** Causes ****_multi_**nucleated _giant_ cells** and **_red_** (eosinophilic) **_inclusion_ bodies** → found **in **_lymph_**oid** tissue (AKA **_Warthin–Finkeldey_** **cell**) **\*\*\* _NO_** Neuraminidase (NA)**!!! \*\*\***

Answer 11

**_Paranormal Mixer_** Vitamin A can **reduce mortality** and **complications**

Answer 12

**_Paranormal Mixer_** * **_MMR_ vaccine!** * **Live attenuated** vaccine to induce humoral and cell mediated immunity. * **Do _NOT_ give to _pregnant_** women. * **_HIV_ pt** should **only** get the vaccine if **CD4 count** is \> **_200_.**

Answer 13

**_Paranormal Mixer_** * **Fever**, muscle **pain**, **headache**, and feeling **tired**. * Usually **followed by _painful swelling_** of **one** or **both** **_parotid_\* _salivary_ glands**. * **_Orchitis_****\*** (inflammation of testicle tissue) **unilaterally** (more rarely bilaterally) → can lead to **impaired fertility** and **testicular atrophy.** * **Meningitis\*** **\*** (**Mumps** **_replicates_ in** the **parotid** glands, **testes**, and **CNS**)

Answer 14

**_Paranormal Mixer_** 1. **Hemagglutinin** (**_HA_**) 2. **Fusion** proteins 3. **Neuraminidase** (**_NA_**)

Answer 15

**_Paranormal Mixer_** * **Attaches to _G protein_** to **infect respiratory** **epithelial** cells * **_Bronchiolitis_** and **_Pneumonia_** (**_most_ common cause** of these **in _infants_!!!**) * **Rhinitis** and **Pharyngitis**

Answer 16

**_Paranormal Mixer_** * **_Fusion_ proteins** (NO HA or NA for RSV) **Fusion proteins** on the surface of the virus **cause** the **cell membranes** on **nearby giant** multinucleated **cells** **to merge** and **stick** together, **forming _syncytia_**.

Answer 17

**_Paranormal Mixer_** * ****_Rib_**avirion** for **adults**.**\*** **\*** (**_Not_** _children_ or _pregnant_ women!!!) * **_Palivisumab_**, a **monoclonal antibody** (**Ig**_G_****) **against** the **_F protein_** of RSV, is used for **high risk children** and **premies**.

Answer 18

**_The suiters of pseudo Mona_** gram (**-**) bacillus obligate **Aerobe** oxidase (**+**) catalase (**+**) **_Blue green_** pigment when **plated** (from **Pyocyanin** and **pyoverdin**, may even turn wounds blue) **Encapsulated**

Answer 19

**_The suiters of pseudo Mona_** **\*** Thrives in **aquatic** environments (**_HOT TUB FOLLICULITIS_**) * **⬆ risk** if pt has **_Chronic Granulomatous Disease_** * **Fruity _grape_** like **odor** * May turn **wounds _blue_** (from **Pyocyanin** and **pyoverdin**) * **Most common** gram (**-**) **Nosocomial _Pneumonia_** * **_Osteomyelitis_** in **IV drug** **users** and **diabetics** * **UTI's** (catheters!) * **Burn patients** are especially susceptile * **Ecthyma gangrenosum** * **Otitis Externa** (_**Swimmers** **ear**_)

Answer 20

**_The suiters of pseudo Mona_** Respiratory failure in **_CF patients_**. **Most common** gram (**-**) Nosocomial Pneumonia. (CL- channels dysfunctional in CF)

Answer 21

**_The suiters of pseudo Mona_** ****_Exo_**toxin A** **_Ribosolation_** of **EF**_2_**** → **_inhibition_** of **protein synthesis** and **cell death**

Answer 22

**_The suiters of pseudo Mona_** **Piperacillin** (penicillin) **amingoglycosides** and **Fluoroquinolones**

Answer 23

**_The pirates of Calam Island_** gram **indeterminate** (_does not_ gram stain) use **_Giemsa_ stain** or **_NAAT_ test** (aka PCR) obligate **_intra_**cellular (**cannot create** its own **_ATP_**, like ricketsia) **Lacks muramic acid** in the cell wall. **Elementary** and **Reticulate** bodies.

Answer 24

**_The pirates of Calam Island_** **_Elementary_** bodies: 1st stage of life cycle **outside of cell**. The **_infectious_ form!** **_Elementary enters_** the eukaryotic cell and is taken up by phagosomes. **_Reticulate_** bodies: **_Dividing_ form! _Reticular replicates_** to form **inclusion bodies** seen under microscope **in cells** when infected. \*After bacteria replicate with its host cells, they leave the cell and become elementary stage again

Answer 25

**_The pirates of Calam Island_** **_3_ main groups** of _C. Trachomatis_ 1. **A-C** → Blindness 2. **D-K** → STI 3. **L1-L3** → LGV **\* "Can't see, Can't pee, Can't climb a tree" (Reiter's syndrome)**

Answer 26

**_The pirates of Calam Island_** C. trachomatis **_A-C_** → **Blindness** Trachoma is the **leading cause** of **blindness in** the **world!** **Transmission** is usually from **_hand to eye_** **contact**, but can also be from **fomites** (objects like clothes or phones) **\*** mnemonic "A-_C (see) with your eyes_"

Answer 27

**_The pirates of Calam Island_** C. trachomatis **_D-K_** → **STI** * **Most common** bacterial **STI** in the **U.S.** * **_Watery_ discharge** (vs. Gonorrhea with mucoprulent). * Can lead to **PID** w/o symptoms or **ectopic pregnancies**. * If mother has it during **delivery** can lead to **_neonatal_ _conjunctivitis_ and _pneumonia_**. Presents **in _1-2 weeks_** (vs. Gonorrhea in 2-4 days) as possible **staccato cough** (short sudden bursts with breath inbetween) or **conjunctivitis**.

Answer 28

**_The pirates of Calam Island_** C. trachomatis **_L1-L3_** → **LGV** (**_L_**ympho**_g_**ranuloma **_V_**enerum) (also is **an STI**) * Starts with **painless** genetial **ulcer** (similar to syphilis) * Presents as **_tender_** **lymphadenopathy** with **_draining_** lymph nodes.

Answer 29

**_The pirates of Calam Island_** _Reiter's_ syndrome **Triad** 1. Cant **see** (_Conjunctivitis_) 2. Can't **pee** (_Urethritis_) 3. Can't **climb a tree** (_Arthritis_) **\*** **_Reactive arthritis_** due to **cross reaction** of **antibodies** fighting chlamydia hitting the **_knee_** or **_sacroiliac joint_**.

Answer 30

**_The pirates of Calam Island_** Macrolides - **Azithromycin** Tetracycline - **Doxycycline** \* also **_tx for Co-infection_** of **Chlamydia** and **Gonorrhea** with **_cephtriaxone_**

Answer 31

**_The pirates of Calam Island_** **Walking** (_atypical_) pneumonia. More commoin in the **elderly.**

Answer 32

**_The pirates of Calam Island_** **Transmitted** by **_birds_** and **_bird droppings_**. Causes **pneumonia!**

Answer 33

**_Walking on thin ice_** gram **indeterminate** (_does not_ gram stain, **no cell walls**) **_Cholesterol_ in** the **membrane** (sterols help stabilize cell membrane and allow flexability) Grown on **_Eatons_ agar** ("**dont eat on ice"**; takes **\>1 week** so not often used) **_Patchy infiltrates_** on **XRAY** (_Walking pneumonia_, XRAYs appears much worse then pt does clinically) Test for **IgM _cold_ agglutination**

Answer 34

**_Walking on thin ice_** **Walking** pneumonia **_Young_ adults** (**\<30** years old) _Crowded areas_ (**military recuits** etc) **IgM** molecules that **agglutinate** red blood cells **in cold temperatures** → lysis of RBC's (**1-2 weeks** into infection)

Answer 35

**_Walking on thin ice_** Macrolides - Zpack (azithromycin)

Answer 36

**_The SS cysteine joins the legion_** gram (**-**) bacilli visualized under **_silver_ stain** oxidase (**+**) **_Charcoal yeast_ extract agar** with **_cysteine**_ and _**iron_** added. Rapid **urine antigen** test to confirm

Answer 37

**_The SS cysteine joins the legion_** * **_Pontiac Fever_**: Fever and malaise, usually self limiting. * **_Legionnaries_** **Disease**: common in **smokers** and **elderly men**. * **_Atypical_ pneumonia** w/ **_patchy_ **_uni_**lobed infiltrate**. * ****_Hypo_**natremia** (excess HNO₃ ammonia Na. wasteing salt) * **Neurologic symptoms**: headache w/ confusion * **_Diarrhea_** * **High _fever_** **over **_104_**F**! \* (high yield: pneumonia w/ diarrhea & hypnonatremia)

Answer 38

**_The SS cysteine joins the legion_** **_Zinc Melloprotease_** is the main VF It's ****_cyto_**toxic** and **_inhibits_ PMN** production, **_inhibits_ superoxide reduction**, **_deactivates_ il-1** and **CD4** and **TNF**

Answer 39

**_The SS cysteine joins the legion_** **macrolides** and **fluoroquinolones**

Answer 40

**_Board and Care_** **(for vets!!!)** gram (**-**) bacilli Aerobic **_Lymphocytosis_**: (ADP disables chemokine receptors for lymphocytes → lymphocytes unable to enter lymphoid tissue → ⬆ WBC in bloodstream )

Answer 41

**_Board and Care_** **(for vets!!!)** **Respiratory droplets** are **very** infective due to their **_pilus_** (called **filamentous hemagglutin**) **3 _toxins_**; **Pertussis** toxin, **Adenylate cyclase** toxin (**_most virulent_**), and **Tracheal** toxin

Answer 42

**_Board and Care_** **(for vets!!!)** **3 _toxins_**: 1. _**Pertussis** toxin_ → **_Ribosylates_ G_i** (G inhibitor protein), disabling it 2. _**Adenylate cyclase** toxin_ (**_most virulent_**) → acts like anthracis toxin **_edema factor_** → **⬆ cAMP** 3. _**Tracheal** toxin_ → **damages _ciliated cells_** in the **epithelium**

Answer 43

**_Board and Care_** **(for vets!!!)** 1. _**Catarrhal** stage_ → Last **1-2 weeks**. **Nonspecific** symptoms of **URI** such as low-grade fever, nasal congestion. **_MOST_ contagious**!!! 2. _**Paroxysmal** stage_ → Last **2-8 weeks**. **Paroxysms** of **coughing** followed by **_inspiratory whoop_**. 3. _**Convalescent** stage_ → Last **weeks to months**. **Subsiding** cough (_100 day_ cough). **_MOST_ susceptible** to **secondary infections**!!!

Answer 44

**_Board and Care_** **(for vets!!!)** **Macrolides** Very useful for **removing** from **respiratory tract**, but not as useful if circulating

Answer 45

**_Board and Care_** **(for vets!!!)** **_DTaP_** **_Acellular_ vaccine** using **purified antigens**

Answer 46

**_Hospital room scene_** gram (**-**) bacilli Ferments **Lactose** → turns **_pink_** on **MacConkeys**

Answer 47

**_Hospital room scene_** **Very _motile_**

Answer 48

**_Hospital room scene_** **Very _motile_** **Red** pigment when **cultured** (like a pink ring around shower or bright red) Catalase (**+**)

Answer 49

**_Hospital room scene_** **\* _3 A_'s!!!** (_Alcoholics_, _Abscesses_, _Aspiration_) **\*** **sputum** that is **_red_** color **Klebsiella** is ****_Im_**motile** Urease (**+**) Polysaccharide **capsule** Cavatary "**TB like**" lesions

Answer 50

**_Hospital room scene_** Multi Drug Resistant **Carbopenam** or **Clindamycin**

Answer 51

**_The golden staff of moses_** gram (**+**) cocci catalase (**+**) coagulase (**+**) **ß** hemolytic Ferments **Mannitol Salt** Agar (turns **_yellow_**)

Answer 52

**_The golden staff of moses_** **Protein A** component of cell wall that binds to **FC** region of antibodies

Answer 53

**_The golden staff of moses_** **Pneumonia** -patchy infiltrate on x-ray **Septic arthritis** **Large erythematous abcesses** **Tricuspid valve endocaritis** -IV drug users **Scalded skin syndrom** **Toxic shock syndrome**

Answer 54

**_The golden staff of moses_** **Toxic Shock Syndrome (TSS)** - commonly caused by leaving in a **bandage** or **tampon** - causes nonspecific **binding of MHC II** to **T cell receptors** causing **over reaction** and **_cytokine storm_** - **TSST superantigen**

Answer 55

**_The golden staff of moses_** -due to **preformed toxins** (not the actual organisms) -usually from **meats** and **mayonnaise** (also salad and creme filled pastries) -usually sick in **6 hours**

Answer 56

**_The golden staff of moses_** **Vancomycin** for methicillin sensitive S. aureus use: **Nafcillin** ("Naf for staph")

Answer 57

**_The Historians Cave_** **Macrophages** w/ ****_intra_**cellular** **_oval_ _bodies_**. Histoplasma is MUCH **_SMALLER_** _than **RBC.**_ **Diagnosis** through **_KOH_**, **rapid _serum**_, or _**urine_ antigen test**. **Dimorphic** (mold in cold, yeast in beast).

Answer 58

**_The Historians Cave_** **Bird** or **_Bat_ droppings** **_Caves_** or **Chicken coops** **Mississippi** (His on the Mis!) and **Ohio** river valleys (**_Midwestern_** **US**) Transmitted through **respiratory**

Answer 59

**_The Historians Cave_** * Pneumonia * **_Granulomas_** (can look like TB) **w/ calcified nodes** and **nodules** in the **hilar region**. * **_Erythema nodosum_** (**_painful_ _red_ nodules**, usually found on **shin**) * **_Hepatosplenomegaly_** (In the **_immunocomprised_**) because the **fungus targets** the **reticuloendothelial** system that has a lot of **macrophages** (which are prevalent in the liver and spleen!)

Answer 60

**_The Historians Cave_** _For **local** and **mild** infections_: **Azole drugs** _For **systemic** infections_: **AMP B**

Answer 61

**_Presidio San Joaquin_** Non-budding **Spherules** packed w/ **_endospores_** (not yeast!) in the **lungs**. Coccidioides are **_LARGER_** _than **RBC**_. **Diagnosis** through **_KOH_**. **Ig**_M_** against Cocci** indicates **_recent_ infection**. **Dimorphic** (mold in cold, spherule of endospore in the body! NOT yeast !)

Answer 62

**_Presidio San Joaquin_** **_Dust_** Very common after **earth quakes**. **_CA_** **and** **_SW_** **US** Transmitted through **inhalation**

Answer 63

**_Presidio San Joaquin_** * **Asymptomatic** in most * May see **pneumonia**, **knee pain**, and **fever** * **Radiology** may be **unremarkable**, or may show **cavaties** and / or **nodules** * **_Erythema nodosum_** (**_painful_ _red_ nodules**, usually found on **shin**) * In the **_immunocomprised_** it can **spread to** the **bone**, or cause **meningitis**

Answer 64

**_Presidio San Joaquin_** _For **local** and **mild** infections_: **Azole drugs** _For **systemic** infections_: **AMP B**

Answer 65

**_The blast of the cannon_** **Broad** Based **_Budding_** Blastomycoses is typically the **_same size as_** **_RBC's._** **Diagnosis** through **_KOH_**, or with a **_urine_ antigen test**. **Dimorphic** (mold in cold, yeast in beast).

Answer 66

**_The blast of the cannon_** **Great lakes** and **Ohio** river valley **_Southern_** **and** **_Southeastern_** **US** Transmitted through **spores** via **inhalation**

Answer 67

**_The blast of the cannon_** * **_Patchy alveolar infiltrate_** on XRAY (**"haziness"**) * **Granulomatous** **_lesions_** in the lungs * **Systemic** infections in the **immunocomprised → Osteomyelitis,** damages **skin** and **bones.**

Answer 68

**_The blast of the cannon_** _For **local** and **mild** infections_: **Itraconazole** _For **systemic** infections_: **AMP B**

Answer 69

**_Piratas del Sur (south)_** **Multiple buds** **radiating** out from a **central vacuole** "**_Captains wheel_**" appearance **_Paracoccidioides_** are a **_LOT LARGER_** _than **RBC's.**_ **Dimorphic** (mold in cold, yeast in beast).

Answer 70

**_Piratas del Sur (south)_** **_South_ America** Transmitted through **respiratory droplets**

Answer 71

**_Piratas del Sur (south)_** * **Lymphadenopathy** **in** **_chains_** of lymph nodes **in** **_cervical_ region**. * Progressive to lungs, causing **granulomas** * **_Mucosal_ ulcers** and **_cutaneous_ lesions** in the **upper mouth** and **gums** → small **hemorrhages** with **ragged borders** * Starts in upper respiratory and moves down, can also be seen in axiallary or inguinal lymph nodes

Answer 72

**_Piratas del Sur (south)_** _For **local** and **mild** infections_: **Itraconazole** _For **systemic** infections_: **AMP B**

Answer 73

**_Asparagus Farm_** Catalase (**+**) **\*** ****_A_**cute** branching (**\< 45º**) with ****_s_**eptations** (**_As_**pergillus) (ddx Mucor which has 90º branching and is nonseptate) **\*** Candida also catalase (+). **Catalase (+)** **↑ risk of Chronic Granulomatous Disease (_CGD_)**

Answer 74

**_Asparagus Farm_** Aspergillus fumigatus is found nearly everywhere in **soil** and decaying plants (like **compost heaps**), and generally won't infect healthy people. They are **condiospores** with **fruiting bodies** that get **inhaled** by human.

Answer 75

**_Asparagus Farm_** 1. **Allergic** **b**roncho**p**ulmonary aspergillus (ABPA) 2. Aspergillosis causing **aspergillomas** 3. **Angioinvasive** aspergillosis

Answer 76

**_Asparagus Farm_** Causes **asthma**, **wheezing**, **fever**, and a **_migratory_ pulmonary infiltrate**. **Type 1** **_hyper_**sensitivity, **IgE** response.

Answer 77

**_Asparagus Farm_** Associated with **_TB_** (**susceptibility ↑** with TB **cavities**) **Aspergillomas** are **gravity dependent** so **fungus _balls_** will be **at the _bottom_ of** the **cavity**

Answer 78

**_Asparagus Farm_** Seen **in pt with **_neutro_**penia** from **leukemia** or **lymphoma**. Aspergillus **invades blood vessels** and the surrounding **tissues**. Leads to **kidney failure**, ****_endo_**carditis**, **_ring enhancing lesions_** in the **brain**. Invades **nasal sinus** (causing **Angioinvasive** aspergillosis) leading to **hemoptysis** (coughing up blood) or blood stained mucos.

Answer 79

**_Asparagus Farm_** **_Aflatoxin_** associated with **_peanuts_** or **_grain_!** Can lead to ****_Hepato_**cellular carcinoma** (_HCC_)

Answer 80

**_Asparagus Farm_** _For **less serious** infection_s: **Voriconazole** _For **angioinvasive** disease_: **AMP B**

Answer 81

**_Crypt for Cryptococcus_** * Cryptococci are **heavily encapsulated**. * **Repeating _polysaccharide_ antigen**. Can be detected by **_Latex agglutination_ test** by causing **agglutination**. * Urease (**+**) * **Bronchopulmonary washings** of lung tissue that resembles **_soap bubbles_**. (can be stained with **mucicarmine _red_** or **methanamine _silver_** **stains**). * **Lumbar puncture** and **_India ink_** will show **wide _encapsulated halos_** (Negative stain! Dark background with transparent organisms)

Answer 82

**_Crypt for Cryptococcus_** Transmitted by **_pigeon droppings_**! Also found in **soil**. **Inhaled** into **lungs**.

Answer 83

**_Crypt for Cryptococcus_** * _**Opportunistic** **infection**_. **HIV**, High dose **steroids**, **Malignancies**. * **_Pulmonary symptoms_** like **cough**, **dyspnea**, **pneumonia** and other lung infections. * Can **_spread to the CSF_** and cause **meningitis**, often leading to permanent **neuro deficits**. * **_Fever_** * Distinct pathology of **brain** having **_soap bubble_ lesions**.

Answer 84

**_Crypt for Cryptococcus_** **Joint therapy** with **_AMP B_ and _flucytosine_**... Then **_fluconazole_ after**

Answer 85

**_Shoot out at the TB Corral_** * **_Acid fast_** (**carbol fuschien** stain; **mycolic** acids) * **_Lowenstein_ medium** * Obligate **Aerobe** * Test for TB with **PPD**, _BCG vaccine_ will _always show_ (+) skin test. * Proliferates in **macrophages** * **Clumping** of bacteria into **serpentine** formation (**_cord factor_**)

Answer 86

**_Shoot out at the TB Corral_** * **_Cord factor_** (**Glycolipid** responsible for **clumping** of bacteria **into _serpentine_ formation**_)_. * **_Sulfatides_** (**prevent phagolysosome** fusion).

Answer 87

**_Shoot out at the TB Corral_** * Human to human respiratory spread. * _**Cord** factor_ ⬆ **granuloma** formation by ⬆ **_TNF-a_**. (Allows TB to attract and hide in macrophage granulomas) * **_Sulfatides_** **prevent** _phagolysosome_ fusion (Allows TB to survive in macrophages by **creating incompetent secondary lysosomes** preventing fusion with phagosomes to prevent phagolysosome formation, thus **avoiding exposure** to the **lysosomal hydrolases**)

Answer 88

**_Shoot out at the TB Corral_** 1. **Healed latent** infection 2. **Systemic** infection (**Miliary** TB) 3. **Reactivation** TB

Answer 89

**_Shoot out at the TB Corral_** * Primarily **lower** or **middle lobes** of lungs. * Usually in **_children_** * **_Long_ fever** * usually **resolves** by **fibrosis** and becomes **latent** * **GHON** complex * TB resides in broken down **necrotic macrophages** (**_Langerhans_ giant cells**) → **Caseation Granulomas**

Answer 90

**_Shoot out at the TB Corral_** **Visual calcification** of **lung parenchyma** and **hilar lymph** **nodes.** (Hilar lympadenopathy + peripheral granulomatous lesion in middle or lower lung lobe). Lesion heals → eventually becomes fibrotic and calcifies, along with nearby draining (hilar) lymph nodes.

Answer 91

**_Shoot out at the TB Corral_** **Type _4_** **hyper** sensitivity reaction _**PPD** will show **positive for**_: 1. active infections 2. latent infections 3. prior **BCG vaccine** (attenuated)

Answer 92

**_Shoot out at the TB Corral_** * **_Multi-organ_ failure** * Primarily bone, liver, and lymphatics, but can spread to any organ in the body * Can be **lethal**

Answer 93

**_Shoot out at the TB Corral_** * Usually in **_upper_ lobes** * **Associated with** **immunosuppression** (HIV, old age, cancer) **through** the **_⬇ regulation_** of **_TNF-a_** release * Always **screen** for PPD before using TNF inhibitors!!! * **_Cough_**, **_night_ sweats**, **_hemoptysis_** (bloody cough) * **_Cachexia_** (body wasting) * **Skeletal** system**: _Pots_ disease** * **CNS** involvement: _meningitis_ or t**_uberculoma_** (cavitary lesion) in 10-15% of reactivations

Answer 94

**_Shoot out at the TB Corral_** When TB infects the **spinal column**. Usually **multiple vertebrae**. **Demineralization** of the bone, **spinal** **weakness**, **soft** tissue **swelling** (swelling leads to **pain**). **Can lead to abcess** formations, spinal **deformities**, and **weakness** due to loss of support.

Answer 95

**_Shoot out at the TB Corral_** mnemonic **RIPE** * **R**ifampin * **I**soniazid * **P**yrazinamide * **E**thambutol _For **prophylaxis**_: **R**ifampin and **I**soniazid for 9 months

Resp Exam 3 Flashcards

(119 cards)