Term
|
Definition
Fever
Nightsweats
Chest pain
cough
hemoptysis
cachexia |
|
|
Term
|
Definition
| TB infection in the lymph nodes in the neck |
|
|
Term
| TB was the (1st/ 2nd/ 3rd) leading cause of death |
|
Definition
| 2nd leading cause in 1990 |
|
|
Term
| Incidence = prevalence when... |
|
Definition
The disease is very lethal or very short
Bubonic plague
common cold (because very short) |
|
|
Term
| Prevalence > incidence when... |
|
Definition
Disease doesn't kill you, but is long lasting
HIV
Cancer |
|
|
Term
|
Definition
HIV is the largest
Silicosis
poverty... |
|
|
Term
| TB infects what proportion of people in the world? In the us? |
|
Definition
1/3
13,000 prevalent cases in the us |
|
|
Term
| how many new cases of TB each year globally |
|
Definition
|
|
Term
| Factors that fueled resurgence of TB |
|
Definition
Rise in HIV
Outbreaks in congregate settings (homeless shelters)
Immigration from countries where TB is common
Multidrug resistant strains
Public health funding ceased |
|
|
Term
| What year did TB cases start to rise again after dropping |
|
Definition
|
|
Term
| What is the biggest risk factor for TB? |
|
Definition
|
|
Term
| TB infection rates of HIV and non-HIV |
|
Definition
10% per year for people with HIV
10% over lifetime for non-TB |
|
|
Term
|
Definition
| Resistant to at least any 2 TB drugs (but not both INH and RIF |
|
|
Term
| Multidrug resistant (MDR TB) |
|
Definition
| Resistant to at least INH and RIF |
|
|
Term
| Extensively Drug resistant (XDR TB) |
|
Definition
| Resistant to IZN, RIF, any fluoroquinolone, and at least 1 of 3 injectable second line drugs (amikacin, kanamycin, or capreomycin) |
|
|
Term
|
Definition
1. Data needs to be reliable
2. notifications must reflect trends in incidence
3. notification should reflect all TB cases |
|
|
Term
|
Definition
| Halve the prevalence and mortality of TB by 2015 |
|
|
Term
|
Definition
1. gov commitment
2. case detection by predominant passive case finding
3. standard short course chemotherapy
4. system of regular drug supply
5. monitoring system for program supervision |
|
|
Term
| Characteristics of Mycobacteria |
|
Definition
Aerobic
Non-motile
Gram positive |
|
|
Term
| Does the PG cell wall of MTB stain with crystal violet? |
|
Definition
|
|
Term
| MTB cell wall characteristics |
|
Definition
Thicker than standards
hydrophobic
waxy
rich in mycolic acid |
|
|
Term
| Mycolic acid cell wall makes MTB ... |
|
Definition
| resistant to disinfectants and dry conditions |
|
|
Term
| acid fast smear can be done on |
|
Definition
1. expectorated sputum
2. induced sputum
3. broncho-alveolar lavage fluid
4. gastric washings |
|
|
Term
| Steps of ZN acid fast staining? |
|
Definition
1. carbol fuchsin
2. heat
3. acid alcohol (decolorizer)
4. Methylene blue (counterstain) |
|
|
Term
| Why is kinyoun stain better? |
|
Definition
| It doesn't need heating because of extra phenol |
|
|
Term
| For slide examinations of AF staining, a higher ZN score means more or less bacteria? |
|
Definition
|
|
Term
| What air conditions do you store TB in? |
|
Definition
| 10% CO2, not just 100% oxygen |
|
|
Term
| What phenotypic methods do you identify TB under? |
|
Definition
1. growthrates
2. pigmentation
3. temp effects on growth |
|
|
Term
|
Definition
First to think TB was contagious
From Miasma (Bad Air) |
|
|
Term
|
Definition
|
|
Term
|
Definition
Injected TB patient fluid into rabbit
Demonstrated infectious nature of TB |
|
|
Term
|
Definition
Identified mycobacterium TB
PPD skin test |
|
|
Term
|
Definition
|
|
Term
|
Definition
Solidified TB was airborne using guinea pigs and ventilation
UV radiation decreases Tb transmission |
|
|
Term
| Factors for transmission of TB |
|
Definition
1.crowded living
2. poor ventilation
3. Malnutrition
4. poverty
5. indoor air polution
5. tobacco
6. HIV |
|
|
Term
|
Definition
| Organized collection of macrophages |
|
|
Term
|
Definition
| When center of granuloma becomes necrotic |
|
|
Term
|
Definition
lesion in subpleural zone of lung
2. Brief acute inflammation
3. Granuloma formation
4. Immunity development |
|
|
Term
| Chest Xray of primary pulmonary TB |
|
Definition
endlarged mediastinal/ hilar nodes
lower lobe infiltrates |
|
|
Term
| Chest Xray of reactivation (Pulmonary) TB |
|
Definition
Upper lobe infiltrates
cavitary lesions |
|
|
Term
|
Definition
TB infection of pleural space with fluid acumulation
Empyema (Pleural effusion) |
|
|
Term
|
Definition
| Pus collection in areas of the chest wall, prostate, liver, spleen |
|
|
Term
|
Definition
Millet seeds all over the body
Typhoidal |
|
|
Term
|
Definition
Infection in meningeal space
Headache, feer, vomiting, confusion
Focal neurologic signs
High mortality |
|
|
Term
|
Definition
Infection of pericardium (effusion present)
Fever, chills, congestive heart failure |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
Renal cortex infection
Sterile pyuria |
|
|
Term
|
Definition
Diarrhea
abdominal pain
all locations can be involved |
|
|
Term
|
Definition
Infection of peritoneal membrane (abdomen)
Due to ascites withhigh protein content |
|
|
Term
|
Definition
infection of adrenal glands with destructions
Fatigue
weakness
nausea/; vomiting
low BP
hypoglycemia |
|
|
Term
|
Definition
| upper lob, pleural disease, cavities |
|
|
Term
| Advanced HIV + TB disease |
|
Definition
lower and middle lobe infiltrates
nodular infiltrates
No cavities
pleural and pericardial disease |
|
|
Term
| Methods to administer TST |
|
Definition
Multipuncture test
Intradermal mantoux test |
|
|
Term
|
Definition
HIV infected
recent contact with infectous TB
CXR consistent with latent TB
immunosuppressed |
|
|
Term
|
Definition
BCG vaccine
Recent immigrant
IV drug user
congregation setting
children <10% |
|
|
Term
|
Definition
|
|
Term
| What immune condition causes you to fail TST with a false negative |
|
Definition
|
|
Term
|
Definition
first test (if + then infected)
second test (if + then infected
if neither is + then consider negative |
|
|
Term
|
Definition
IFN gamma releasing assay
whole blood
Ex vivo |
|
|
Term
|
Definition
only one visit
not operator dependent |
|
|
Term
|
Definition
|
|
Term
| How to Diagnose active TB |
|
Definition
Clinical examinations
- PPD skin test
- X ray
- bacteriological examination
specimen collection
smear examination (AFB)
culture
mycolic acid (HPLC) |
|
|
Term
| What is the only way to confirm TB? |
|
Definition
|
|
Term
| Anti-TB medications 3 main desireable properties? |
|
Definition
1. Rapidly eliminate majority of active bacilli
2. Kill dormant bacilli
3. prevent emergent of resistant |
|
|
Term
Cavitary Lung disease
Extracellular environment |
|
Definition
| Prime location for natural selection of drug-resistant mycobacteria |
|
|
Term
Cavitary Lung disease
Within macrophages |
|
Definition
Slow growing
acidic environment limits utility of many anti-TB meds |
|
|
Term
Cavitary Lung disease
Within solic caseous granulomas |
|
Definition
Slow goriwntg
blood flow limited |
|
|
Term
|
Definition
Targets formation of mycolic acids
penetrates well
Given orally (and IV)
Side effects:
Hepatitis
Peripheral neuropathy
Pyroxidine
Ethionamide |
|
|
Term
|
Definition
Rifamycins Inhibit DNA dependent RNA pol
Potent against actively deviding and semi-dormant organisms
required for short course
penetrates well
Given orally and IV
Problem:
upregulates cytochrome P-450 oxidase
Dye |
|
|
Term
|
Definition
Disrupts membrane activity and transport
Effective in eliminating persisting organisms
Required to shorten course to 6 months
Given orally
Adverse:
Liver toxicity
More likely hepatitis
Elevated uric acid |
|
|
Term
|
Definition
Inhibits cell wall by arabinogalactan
Bacteriostatic
Given orally only
Adverse:
Opitic neuritis
Color blindness
Similar to Cycloserine |
|
|
Term
|
Definition
Aminoglycosides
inhibit protein synthesis
Toxicity
Kidney
ototoxicity (ears) |
|
|
Term
|
Definition
similar to aminoglycosides
inhibits protein syntehsis |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
Ethionamide
and
Similar to? |
|
Definition
Inhibits mycolic acid synthesis
oral only
Toxicity:
GI distress
peripheral neuropoathy
similar to INH |
|
|
Term
Fluorquinolones
Moxifloxacin/ levofloxacin |
|
Definition
Inhibits DNA gyrase
well tolerated |
|
|
Term
|
Definition
Inhibits cell wall synthesis
available orally
Toxicity
peripheral neuropathy
CNA dysfunction, headache, a ton of stuff
Similar to EMB |
|
|
Term
Para-aminosaalicylic acid
PAS |
|
Definition
|
|
Term
|
Definition
Inhibits protein synthesis
adverse:
Bone marrow suppression
neurotoxicity
Similar to Streptomycin
amikacin, kanamycin, |
|
|
Term
|
Definition
novel mechanism of action
tested against all drug resistant isolates |
|
|
Term
| Treatment of drug susceptible TB |
|
Definition
2 months of 4 primary defense
4 months of INH/RIF
continuation period of 8 months INH/RIF |
|
|
Term
| Completion of treatment. PPD results? |
|
Definition
|
|
Term
|
Definition
| INH monotherapy for 9 months |
|
|
