Lecture 11

 

Question 1 of 49

What was the mortality rate of TB 100 years ago?= 20%

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Question 2 of 49

How did TB used to be considered? (3)= "Not contagious, respectable people infected, not bad symptoms"

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Question 3 of 49

Who identified the infectiousness of TB?= Jean Antoine Villemin

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Question 4 of 49

Who discovered mycobacterium tuberculosis?
Robert Koch

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Question 5 of 49

What are characteristics of MTb? (5)
"Lipid cell wall, acid fast bacilli, slow growing, resistant to antibiotics, lives in macrophages"

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Question 6 of 49

How many TB infections every year?
2B

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Question 7 of 49

How many deaths around the world are attributed to TB?
1.5M

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Question 8 of 49

Which countries are especially susceptible to death by TB? (5)
"India, Indonesia, China, Philippines, Pakistan"

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Question 9 of 49

How does HIV relate to TB?
HIV patients 20X more likely to develop TB

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Question 10 of 49

How many cases of TB each year in NZ?
300

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Question 11 of 49

How do people come to be diagnosed with TB? (3)
"Symptomatic case, immigrant screening, contact tracing"

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Question 12 of 49

What is the major age group where TB affects NZrs?
15-40

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Question 13 of 49

Where in NZ are the most TB cases?
"Central North Island, Auckland"

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Question 14 of 49

What are the risk factors for NZrs contracting TB? (4)
"Born outside NZ, living with person born outside NZ, contact with confirmed case, immumnosuppresive illness"

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Question 15 of 49

Which ethnicity has the highest cases of TB?
Asian

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Question 16 of 49

When are the major periods of length of stay in NZ before TB is diagnosed? (2)= "1-2 years, 20+ years"

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Question 17 of 49

How is Tb transmitted?
Bacilli inhaled as droplet

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Question 18 of 49

What is the main dose for infection?
5 bailli

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Question 20 of 49

How do macrophages control M. tb? (2)
"Engulf M. tb, form granulomas"

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Question 21 of 49

What is the difficult part of diagnosing M.tb?
Most infections are asymptomatic

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Question 23 of 49

What are the symptoms of progressing TB infections? 
"Chest pains, bloody cough"

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Question 24 of 49

What is the mortality rate of untreated TB?= =50%

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Question 25 of 49

What is the course of TB disease progression? (3)
"Infection (innate immunity, Containment (primary disease, asymptomatic, adaptive immunity), Breakdown (reactivation of disease)"

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Question 26 of 49

How was the original vaccine derived?
From bovine tuberculosis isolate

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Question 28 of 49

What is the type of test determined by? (2)
"Reason for testing (symptoms, contact), resources available"

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Question 29 of 49

What is a cheap way to diagnose TB?
Chest x-ray

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Question 30 of 49

How can M. tb be identified from sputum?
Ziehl-Neelsen stain

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Question 31 of 49

How does the Ziehl-Neelsen stain work? (3)
"Carbol fuchsin (red) in phen set with heat, decolourised, counter stain methylene blue (acid fast)"

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Question 32 of 49

What does Gene expert/PCR detect? (2)= ="Organism, resistance markers"

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Question 33 of 49

How do blood tests identify TB?
Detects release of interferon by lymphocytes (sensitised lymphocytes)

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Question 34 of 49

Can a blood intereron test distinguish between latent infection and disease?
Nope

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Question 35 of 49

How does a Mantoux test work?
(3) "Injection of tuberculin (cell wall extract of Mtb) into dermis, sensitised lymphocytes migrate to site and release interferon, swelling develops and is measured"

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Question 36 of 49

What is a problem with the Mantoux test?
Those BCG vaccinated people will have of +ve Mantoux

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Question 37 of 49

What is the quantiferon gold test?
"Quantiferon antigen (only in Mtb) assayed with venous blood, incubate for 3 days, lymphocytes exposed to Mtb release interferon Y"

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Question 38 of 49

What is the treatment for TB in the first 2 months? (4)
"Isoniazid, rifampicin, pyrazinamide, ethambutol"

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Question 39 of 49

What is the treatment for TB in the following 4 months? (2)
"Isoniazid, rifampicin"

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Question 40 of 49

What are the minor side effects of TB drugs? (6)= ="Rash, red urine, burning feet, nausea, abdominal pain, joint pain"

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Question 41 of 49

What is DOTS?
"For short course treatments, patient is observed to confirm they are taking the drugs"

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Question 42 of 49

What are the major side effects for TB drugs? (4)
"Deafness, Jaundice, Vision impairment, Shock"

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Question 43 of 49

Which drugs are TB resistant to? (@)
"Isoniazid, rifampicin"

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Question 44 of 49

Which countries have the major burden of MDR? (3)
"India, China, Russia"

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Question 45 of 49

What happens to treatment of MDR TB? (2)
"Pyrazinimide, one from group A, one from group B, two from group C"

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Question 46 of 49

What is the result of XDR TB
"Resistance to isoniazid, rifampicin, flouroquinolone, one group B"

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Question 47 of 49

What % of NZ TB are susceptible (not resistant)?
85%

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Question 48 of 49

What does control of TB require?
"Eliminate poverty, animal TB, infectious patients, better diagnosis, faster drug treatment with more tolerable drugs"

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Question 49 of 49

What is TDR TB?
Totally drug resistant

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