Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/24

Click to flip

24 Cards in this Set

  • Front
  • Back
3 species of mycobacteria of importance in humans:
M. tuberculosis- TB
M. leprae- leprosy
M. intracellulare- disseminated disease in immune suppressed
Where do mycobateria replicate in a lung?
alveolar macrophages
Immune response to mycbacteria in the lungs
granulomas
Granulomas become calcified nodules (Gohn complex)
Bacteria within granulomas are unable to replicate but remain viable for how long?
years-decades
Mycobacteria are Acid-fast, aerobic ____
rods
______ tuberculosis (TB) is the widespread dissemination of Mycobacterium tuberculosis from hematogenous spread
Miliary


(1-3% of all TB cases)
6% of Primary tuberculosis is "_______" TB
clinical
90% of primary TB is "_____" TB.
latent
What causes Secondary (reactivated) tuberculosis?
Immune suppression allows latent TB to reactivate
Granulomas break down releasing organisms
Clinical TB results
Manifestations of Reactivated Pulmonary TB
Insidious onset of fever, night sweats, weight loss, anorexia, malaise, weakness
Cough often productive of blood-streaked sputum
Apical and posterior segments of upper lobes most often affected
May see cavitary lesions on CXR
extrapulmonary tuberculosis that affects the spine
Pott disease
Infected macrophages can take TB hematogenously throughout body if _____ law is broken
Jason's
TB:
_____ stain of sputum
Acid fast
TB:
Culture in broth takes up to ___ days
14
agar used to culture TB (takes a month)
Lowenstein-Jensen agar
PPD test:
Within 48 hours, a positive lesion is erythematous and _____
indurated


15mm induration is positive in persons with latent TB
10mm post-PPD induration is positive for:
Recent arrivals from high-prevalence countries ****
Injection drug users
Residents and employees of high-risk congregate settings
Mycobacteriology laboratory personnel
Persons with clinical conditions that place them at high risk
Children <4 years of age, or children and adolescents exposed to adults in high-risk categories
5mm post-PPD induration is positive for:
Immunosuppressed patients (HIV/AIDS, cancer, etc.)****
Persons with fibrotic changes on chest radiograph consistent with old healed TB
First line treatment of TB
Requires 4 drug cocktail
First line drugs
Isoniazid (INH)
Rifampin
Ethambutol
Pyrazinamide
Second line drugs for TB
Streptomycin
Para-aminosalicylic acid
Cycloserine
Ethionamide
Amikacin
Levofloxacin
Capreomycin
Treatment of active TB with 4 drug cocktail lasts for 2 months. Then the pt has CXR and AFB smear. If CXR and smear are NEGATIVE, continue isonaiazid and rifampin for how long?
4 more months

(7 more months if AIDS pt)
Multi-drug resistant TB (MDR-TB)


Resistant to what?
INH and Rif


Can still be treated by substituting second-line drugs
Extensively drug-resistant TB (XDR-TB)
INH, Rif, any fluoroquinolone
and at least one of three injectable second-line drugs
(capreomycin, kanamycin, and amikacin)
For latent tuberculosis, the standard treatment is six to nine months of
isoniazid alone.