Hdm Test 2: Mycobacteria Tb

Front 1

What do you do with Koch's postulate?

Back 1

Isolate, grow, administer to animal, re-isolate from infected animal

Front 2

3 reasons for spike in TB in late 1980s

Back 2

Inc HIV
Inc immigration
Elimination of public health resources

Front 3

MDR Tb

Back 3

resistant to 2 of frontline drugs

Front 4

TDR Tb

Back 4

Total drug resistance Tb (all drugs)

Front 5

XDR Tb

Back 5

Resistant to at least 4 Tb drugs

Front 6

What is the strongest risk factor for Tb?

Back 6

HIV (can accelerate progression)
-harder to diagnose in HIV individuals

Front 7

Mycobacterium is what shape?

Back 7

Bacillus (neither gram+ or gram-)

Front 8

Cell wall of mycobacterium is made of ______

Back 8

mycolic acid

Front 9

stain test for Tb

Back 9

Acid fast stain (purple bars)

Front 10

Air type of Tb

Back 10

obligate aerobe, but can adapt in latency

Front 11

How is Tb transmitted?

Back 11

Aerosols

Front 12

Of immunocompetent people, how many will have reactivated Tb after latent Tb?

Back 12

10%

Front 13

If you are HIV+, what is your risk each year of having active Tb?

Back 13

10%

Front 14

What determines if you are infectious with Tb?

Back 14

Bacteria in the airway, granulomas releasing into airway

Front 15

Where do mycobacterium tuberculosis grow?

Back 15

macrophages (and replicates until killing macrophage)

Front 16

What do macrophages release once infected with Tb?

Back 16

IL-12, driving a Th1 response.
-also presenting antigens (both T cell types)

Front 17

What forms after macrophages are affected?

Back 17

Granulomas, clumps of macrophages surrounded by T-cells to control infection

Front 18

Where is Tb stored during latent infection?

Back 18

In granuloma (not transmissible)

Front 19

What occurs when M. tuberculosis reactivates?

Back 19

Granulomas liquify and triggers overly robust immune response;

Front 20

Symptoms of Tb

Back 20

(all caused by immune response)
long lasting cough
coughing up blood
chest pain
weight loss
fever
night sweats

Front 21

PPD means

Back 21

purified protein derivative of tuberculosis
-just tells you they have a T-cell response
-doesnt work for HIV

Front 22

2nd diagnostic test for TB

Back 22

QuantiFERON test (T cells recognizing Tb-specific antigens)

Front 23

Diagnosis of active TB

Back 23

Acid fast stain of sputum
Xpert (PCR test in 2 hours)
-also IDs MDR-Tb

Front 24

4 frontline drugs for Tb

Back 24

Rifampicin
Isoniazid
Pyrazinamide
Ethambutol

Front 25

Where does M leprae grow?

Back 25

macrophages and Schwann cells

Front 26

In tuberculoid leprosy, what are likely outcomes?

Back 26

Nerve damage and trauma from nerve damage

Front 27

In lepromatous leprosy, what are likely outcomes?

Back 27

Nodular growth

Front 28

MOTT means what?

Back 28

Mycobacteria other than Tb

Front 29

Where are MOTT found?

Back 29

soil/water, southeastern US

Front 30

Transmission of MOTT

Back 30

no person to person passage

Front 31

Which bacteria is common in showers/water supplies?

Back 31

M. avium (hot tub lung)

Front 32

Fast growing MOTT

Back 32

M. fortuitum (common in nail salons)

Front 33

New leprosy? Leads to necrotizing ulcerative lesions

Back 33

M. ulcerans