Respiratory Exam 2 > TB > Flashcards

TB Flashcards

(45 cards)

Study These Flashcards
1
Q

what is the strongest risk factor for developing active TB

A
  • HIV
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2
Q

what appears to accelerate the progression of HIV disease?

A
  • TB
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3
Q

MDR TB defined as resistant to which drugs?

A
  • INH (isoniazid)

- RIF (rifampin)

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4
Q

XDR TB defined as

A
  • MDR strain resistant to two classes of second line drugs
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5
Q

the BCG vaccine is which organism

A
  • mycobacterium bovis
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6
Q

what kind of pathogen is mycobacterium tuberculosis

A
  • facultative intracellular acid fast pathogen
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7
Q

MTB lives primarily where

A
  • in macrophages
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8
Q

what kind of stain do you use for TB

A
  • acid fast stain
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9
Q

what is the defining and unique feature of the mycobacterial cell wall

A
  • mycolic acid
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10
Q

what does mycolic acid form

A
  • myobacterial outer membrane
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11
Q

is there LPS in mycobacteria

A
  • no LPS
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12
Q

MTB is transmitted by

A
  • aerosols
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13
Q

how can MTB survive in macrophages?

A
  • resistance reactive oxygen and reactive nitrogen species

- arrests phagosome maturation at a very early step

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14
Q

what kind of response leads to macrophage activation and MTB control?

what presents the antigen?

A
  • TH1

- TB infected macrophages and dendritic cells

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15
Q

what are recruited to the site of infection in MTB control

A
  • antigen specific CD4 and CD8 T cells
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16
Q

do antibodies play a role in MTB infection

A
  • no
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17
Q

what happens after MTB infected macrophages are recognized by antigen specific CD4 and CD8 cell?

A
  • cytokine production that activates macrophages to control MTB replication
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18
Q

which cytokine controls the TH1 response

what is it released by

what is the result of its release

A
  • IL-12
  • MTB infected macrophages
  • leads to CD4 differentiation along TH1 path
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19
Q

what activates macrophages

what is it secreted by

what other chemical also helps to activate macrophages

Study These Flashcards
A
  • interferon gamma
  • CD4 TH1 type T cells and CD8 T cells
  • TNF-alpha
20
Q

role of activated macrophages

Study These Flashcards
A
  • exhibit more efficient phagosome-lysosome fusion, reactive oxygen and nitrogen species
21
Q

what do activated macrophages wall themselves into

22
Q

what is at the center of the granuloma

what composes the outside of the granuloma

Study These Flashcards
A
  • central region of macrophages, fused macrophages, extracellular bacilli, dead macrophage debris
  • newly recruited activated macrophages and T cells (CD4 and CD8)
23
Q

what is the granuloma walled off by

name of the final product

importance of this

Study These Flashcards
A
  • fibrin coat
  • tubercle
  • what you can see on the X ray
24
Q

what is LTBI

Study These Flashcards
A
  • latent TB infection kept under control by cell mediated immune response
25
what is active TB
- reactivation of TB occurs and triggers an overly robust cell mediated immune response leading to lung damage and symptoms of infectious TB
26
what happens in the cell that can help us realize the transition to active TB
- granulomas liquifying and becoming and becoming a site for extracellular replication of TB
27
symptoms of TB are due to
- cytokine production (IL-1, TNF-alpha) - macrophage activation - CTLs
28
TB in HIV+ individuals why
- primary infection not contained allowing MTB dissemination throughout the body leading to milliary TB they don't have enough T cells to wall off TB
29
miliary TB differential diagnosis include
- fungi | - metastatic tumor
30
chance of TB reactivation after HIV infection
- 10% each year
31
IGRA test measures
- IFN gamma production by T cells upon recognition of TB specific antigens not found in BCG
32
MTB/RIF test measures
- PCR for detection of MTB | - also determines rifampicin resistance
33
which TB drugs are pro-drugs first
- INH (Isoniazid) | - PZA (Pyrazinamide)
34
cause of leprosy
- Mycobacterium leprae
35
forms of leprosy and type of response
- tuberculoid leprosy (TH1 response) | - lepromatous leprosy (TH2 response)
36
which form of leprosy is deformity due to nerve damage with its consequent ulcers and resorption of bone
- tuberculoid leprosy
37
which form of leprosy is activated nodulous lepromatous leprosy
- lepromatous leprosy
38
atypical mycobacteria common where in the US
- southern and midwestern US
39
mycobacterium avium complex found where
- water supply
40
mycobacterium avium transmitted by
- inhalation or ingestion
41
mycobacterium avium causes
- pulmonary or disseminated disease
42
mycobacterium abscessus frequent in which patients
- bronchiectasis, COPD and CF patients
43
mycobacterium abscessus causes which infection
- chronic lung infection | - skin/soft tissue infections
44
mycobacterium abscessus treatable with drugs?
- highly resistant to drugs
45
mycobacterium fortuitum infections associated with
- nail salons & tattoo parlors
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