Lec(s) 15 and 16- Anti-Mycobacterial Agents (Tuberculosis & NTM)

Which of the following is true regarding mycobacteria?

What is the approximate number of people infected with latent TB worldwide?

Which of the following is a common symptom of active TB disease?

A positive tuberculin skin test (PPD) indicates what?

Which characteristic is associated with Mycobacterium tuberculosis?

What is the primary target organ for TB infections?

Which diagnostic method is used to monitor the treatment progress of TB?

Which of the following is a key component of the mycobacterial cell wall and contributes to its unique characteristics?

Which of the following is a common first-line drug used in the treatment of drug-sensitive tuberculosis?

What is the primary mechanism by which Isoniazid (INH) inhibits mycobacterial growth?

Which of the following is a common adverse effect associated with ethambutol?

Which of the following is a potential consequence of spontaneous mutations in M. tuberculosis?

What strategy aimed at preventing the development of drug resistance in tuberculosis involves directly watching patients take their medication?

When treating tuberculosis, why is it important to avoid adding a single drug to a failing regimen?

Which of the following is a key characteristic of rifamycins like rifampin?

What is a common mechanism of resistance to rifampin in Mycobacterium tuberculosis?

What is the primary mechanism of action of pyrazinamide?

Which of the following regarding Non-tuberculous mycobacteria (NTM) is true?

Which of the following is a common source of nontuberculous mycobacteria (NTM) that can lead to infection?

In the context of NTM infections, what does MAC stand for?

Which term describes mycobacteria that are neither M. tuberculosis nor M. bovis?

A patient is diagnosed with a non-tuberculous mycobacterial (NTM) infection. Which of the following factors would increase the risk for this type of infection?

What is the difference between latent TB infection (LTBI) and active TB disease?

How is tuberculosis primarily transmitted from one person to another?

Which of the following is a diagnostic test used to detect latent TB infection?

Which term describes TB that is resistant to at least isoniazid and rifampin?

What is the significance of granuloma formation in TB infection?

Why is combination therapy used to treat Tuberculosis?

What is the role of the katG gene in isoniazid (INH) resistance?

What is the purpose of using pyridoxine (vitamin B6) when treating patients with isoniazid (INH)?

Which of the following is a potential drug interaction associated with rifampin?

Which of the following refers to TB disease outside the lungs?

In HIV-positive patients with TB, if not receiving ART, what modification to the TB treatment is recommended to prevent the occurance of IRIS?

What is the main component for NTM infections?

What is meant by the term 'prodrug'?

What component of bacterial cell wall is targeted by Ethambutol?

If a patient is macrolide resistant, what type of medication would be used?

What is needed for treating Mycobacterium ulcerans?

What is the most likely cause of treatment failures?

Which of the following is true for Macrolides?

What characteristic do mycobacteria possess due to their cell wall composition?

Which of the following is a species of pathogenic mycobacteria other than M. tuberculosis?

What is the term for the group of mycobacteria that are not M. tuberculosis or M. bovis?

Which term describes mycobacteria that can be found almost everywhere?

What is the typical duration of treatment for drug-sensitive tuberculosis using current daily regimens?

What is a potential consequence of spontaneous mutations in M. tuberculosis?

What does DOTS stand for in the context of TB treatment strategies?

Isoniazid inhibits the synthesis of what?

Which of the following is a first-line TB agent that is a bacterial-activated prodrug?

What supplement is often given with isoniazid to prevent peripheral neuritis?

Mutations in which bacterial component leads to Isoniazid resistance?

How does rifampin affect other drugs in the body?

Rifampin works by binding to the beta subunit of what?

What is a common adverse reaction associated with ethambutol?

What cell wall component is targeted by ethambutol?

What is the primary source of NTM in the environment?

Which of the following is a common route of acquiring NTM infections?

What underlying condition increases the risk of nontuberculous mycobacterial (NTM) infection?

Which of the following species is associated with Buruli ulcers?

What antibiotic regimen is recommended for treating Mycobacterium ulcerans?

Which term describes the ability of some bacteria, including mycobacteria, to survive in a dormant state and then become active?

NTM can lead to infection, especially in patients with what condition?

If a patient has a macrolide susceptible MAC, which class of antibiotics would be used?

What can be recommended for a fixed duration of 12 months instead of 12 months beyond culture conversion?

What may be substituted for rifampin to reduce CYP 450 induction?

Which best describes persisters?

Which best describes multi drug treatment?

Why are long durations required for Mycobacteria Disease Treatment?

Why is it important to identify NTM to the species level?

What is the rationale behind using multiple drugs to treat mycobacterial infections?

What is a key reason that mycobacterial infections require long treatment durations?

What is the primary mechanism by which resistance to rifampin develops in Mycobacterium tuberculosis?

A patient with HIV/TB co-infection is starting antiretroviral therapy (ART). When should TB treatment be initiated relative to ART?

What is a significant risk factor for developing non-tuberculous mycobacteria (NTM) infections?

What is the role of katG in the mechanism of action of isoniazid (INH)?

What is a common opportunistic NTM that is often found in AIDS patients?

Which strategy is essential for preventing the development of drug resistance in tuberculosis treatment?

Which statement best describes the mechanism of action of ethambutol?

How do spontaneous mutations contribute to drug resistance in M. tuberculosis?

How does rifampin interact with other drugs in the body?

What is the primary target of pyrazinamide?

Which of the following is true regarding the frequency of spontaneous mutations leading to drug resistance in M. tuberculosis?

Why is vitamin B6 (pyridoxine) often administered alongside isoniazid (INH)?

In treating tuberculosis, how does Directly Observed Therapy (DOT) contribute to preventing drug resistance?

What is Immune Reconstitution Inflammatory Syndrome (IRIS) in the context of HIV and TB co-infection?

What aspect of Mycobacterium tuberculosis cellular structure contributes the MOST to its resistance against many common antibiotics?

Which diagnostic method primarily determines the drug susceptibility profile of Mycobacterium tuberculosis?

What is meant by the term 'prodrug' regarding certain anti-TB medications?

What is a key characteristic of Non-tuberculous Mycobacteria (NTM) regarding their habitat?

What consideration is most helpful for treating a macrolide suceptible MAC?

What is the recommended antibiotic regimen for treating a Mycobacterium ulcerans infection, commonly known as Buruli ulcer?

How does altering efflux pump activity affect drug resistance in mycobacteria?

Besides the more conventional TB antibiotics, what new drugs target MDR/XDR-TB?

Which factor contributes to the intrinsic antibiotic resistance observed in M. abscessus?

What is a potential adverse effect associated with ethambutol?

Which of the following is best to recommend for a fixed duration of 12 months instead of 12 months beyond culture conversion for the treatment of M. kansasii?

What factor indicates that Rifabutin may be substituted for Rifampin?

For pulmonary TB treatment what is the standard regimen?

What is the first step of latent TB treatment?

For a slow growing Mycobacterium, what is the days needed to grow?

Mycobacterium ulcerans starts as what?

Which test can be used on Latent and Active TB testing?

Which test is used to check Active TB?

Which two tests are used to monitor Drug susceptibility?

Which infection can be observed through cervical lymphadenitis?

Which of the following is a key characteristic differentiating pathogenic mycobacteria from opportunistic mycobacteria?

A patient is diagnosed with a disseminated NTM infection. Which of the following species is MOST likely to be the causative agent?

Why is it important to use multiple drugs when treating active TB?

How do spontaneous mutations in Mycobacterium tuberculosis contribute to the development of drug resistance?

What is the primary rationale for identifying NTM isolates to the species level?

What role does mycolic acid play in the characteristics of mycobacteria?

Isoniazid (INH) requires activation within the mycobacterial cell to be effective. Which of the following enzymes is responsible for this activation?

Which of the following mechanisms describes how ethambutol exerts its antimycobacterial effect?

Rifampin is known for its interactions with other drugs. What is the primary mechanism behind these interactions?

A patient on rifampin develops symptoms of hepatitis. Which of the following actions is MOST appropriate?

Why is pyridoxine (vitamin B6) commonly administered alongside isoniazid (INH) in TB treatment?

Which of the following describes the action of pyrazinamide in treating tuberculosis?

How does resistance to pyrazinamide typically develop in Mycobacterium tuberculosis?

A patient with HIV/TB co-infection is about to start antiretroviral therapy (ART). Their CD4 count is <50 cells/µL. According to guidelines, when should TB treatment be initiated relative to ART?

What is the primary advantage of using rifabutin over rifampin in HIV/TB co-infected patients on protease inhibitors?

According to current guidelines, what is the recommended treatment duration for latent TB infection (LTBI) using isoniazid and rifapentine?

Which of the following accurately describes the role of Directly Observed Therapy (DOT) in TB treatment?

Which diagnostic method is MOST useful for rapidly detecting resistance to rifampin in Mycobacterium tuberculosis?

Mycobacterium ulcerans, the causative agent of Buruli ulcer, is MOST commonly treated with which combination of antibiotics?

Which best describes persisters regarding mycobacterial infections?

A patient with a history of pulmonary disease is diagnosed with a Mycobacterium xenopi infection. Which of the following antibiotic regimens is MOST appropriate?

What approach to drug administration is DOT?

Which of the following best explains why long durations are required for Mycobacteria Disease Treatment?

Why is multi drug treatment required for Mycobacterial Diseases?

NTMs are found ubiquitously in the environment. What is the main source?

Which of the listed diagnostic tests are used to check for active TB?

Which of the following best describes a key aspect of TB incidence in the USA?

What is the primary reason for identifying NTM isolates to the species level?

A researcher is investigating the mechanism of action of a new drug targeting Mycobacterium tuberculosis. The drug inhibits the synthesis of arabinogalactan and lipoarabinomannan. Which existing anti-TB drug shares a similar mechanism of action?

A patient on rifampin begins experiencing signs of liver dysfunction. What is the MOST appropriate course of action?

A patient with TB is prescribed isoniazid (INH) and develops peripheral neuropathy. What is the mechanism by which pyridoxine (vitamin B6) helps to alleviate this side effect?

What enzymatic activity of KatG is essential for converting Isoniazid into its active form in Mycobacterium tuberculosis?

Which statement accurately describes the mechanistic action of ethambutol in treating tuberculosis?

How does the development of spontaneous mutations in Mycobacterium tuberculosis typically lead to drug resistance?

What is the role of pyrazinoic acid in the mechanism of action of pyrazinamide against Mycobacterium tuberculosis?

Which factor is MOST crucial when deciding between rifampin and rifabutin for a patient with HIV/TB co-infection?

How does the Directly Observed Therapy (DOT) method enhance the effectiveness of tuberculosis treatment in preventing drug resistance?

What is a defining characteristic of Immune Reconstitution Inflammatory Syndrome (IRIS) in HIV/TB co-infected patients?

What structural characteristic of Mycobacterium tuberculosis MOST significantly contributes to its resistance to many common antibiotics?

Which approach enables the MOST rapid determination of rifampin resistance in Mycobacterium tuberculosis?

Considering the complexity of treating drug-resistant TB, which of the following strategies is MOST effective in preventing the spread of resistance?

A patient has been diagnosed with a non-tuberculous mycobacterial (NTM) infection caused by Mycobacterium abscessus with inducible Erm gene. How does inducible expression of the erythromycin ribosomal methylase (Erm) gene contribute to antibiotic resistance in this species?

Which statement BEST describes how persisters contribute to the challenge of treating mycobacterial infections?

What is the MOST critical reason for employing multi-drug therapy in the treatment of mycobacterial infections?

What factor contributes MOST to the need for prolonged treatment durations in mycobacterial infections compared to other bacterial infections?

How can increased activity of efflux pumps affect antibiotic effectiveness in mycobacteria?

A patient with Mycobacterium xenopi infection has cavitary lung disease with advanced bronchiectasis. Which of the following modifications to the standard treatment regimen should be considered?

What is a primary advantage of using rifabutin over rifampin in treating TB in HIV-positive patients who are also taking protease inhibitors?

According to current guidelines, what is the recommended treatment duration for the preferred regimen for latent TB infection (LTBI) using isoniazid and rifapentine?

Which diagnostic finding would MOST strongly suggest a diagnosis of active TB disease rather than latent TB infection?

Aside from conventional TB antibiotics, which new drugs are currently being used to target MDR/XDR-TB effectively?

Which of the following mutations is MOST likely to result in resistance to rifampin in Mycobacterium tuberculosis?

Which of the following is the MOST appropriate initial treatment strategy for a localized skin infection caused by a rapidly growing mycobacteria (RGM) such as Mycobacterium fortuitum?

An 8 year old is diagnosed with TB meningitis. What modification to the standard treatment would you recommend?

A patient is infected with M. avium complex (MAC) but it is determined their strain is macrolide susceptible. What is the best recommendation for treatment?

Which is true for Mycobacterium ulcerans?

Which of the following is a way in which M. tb becomes drug resistant?

What strategy is directly aimed at preventing the development of drug resistance in TB treatment by ensuring adherence?

For a slow growing mycobacterium, how many days are needed to grow in the lab setting?

For HIV patients with CD4 counts of less than 50, how long should you wait after TB treatment to start ART?

For a macrolide resistant treatment, which medication would be recommended?

What are the first two steps when undergoing treatment for latent TB?

A patient with TB has already failed a drug regimen that included rifampin. What should you avoid doing?

Which diagnostic test can be used for Active and Latent TB?

What is the most common source for NTM infections?

Which are the two tests to check for drug susceptibility?

A patient diagnosed with tuberculosis is prescribed isoniazid. The physician explains that isoniazid is a prodrug. What is the MOST significant implication of isoniazid being a prodrug for its mechanism of action?

Rifampin is known to induce hepatic cytochrome P450 enzymes. Considering this pharmacological property, what is the MOST critical clinical implication when initiating rifampin therapy in a patient already receiving protease inhibitors for HIV?

Ethambutol's mechanism of action involves the inhibition of arabinosyltransferases, affecting the synthesis of arabinogalactan and lipoarabinomannan. Which of the following cellular structures in Mycobacterium tuberculosis is DIRECTLY compromised by this mechanism?

Pyrazinamide is uniquely effective against Mycobacterium tuberculosis in the acidic environment of the phagolysosome. What is the MOST likely reason for this specific activity in acidic conditions?

A patient with active pulmonary tuberculosis is started on a standard 6-month regimen. After two months, a follow-up sputum culture is still positive for M. tuberculosis. However, drug susceptibility testing from the initial isolate shows sensitivity to all first-line drugs. What is the MOST probable explanation for the persistent positive culture at this stage of treatment?

Directly Observed Therapy (DOT) is a critical strategy in tuberculosis treatment. What is the PRIMARY rationale for recommending DOT for patients with active TB?

Mycobacterium abscessus is known for its intrinsic resistance to several antibiotics. Which of the following mechanisms contributes MOST significantly to the inherent antibiotic resistance observed in M. abscessus?

A patient with HIV and newly diagnosed active tuberculosis has a CD4 count of 40 cells/µL. According to current guidelines, when should antiretroviral therapy (ART) be initiated relative to the start of tuberculosis treatment to optimize clinical outcomes and minimize complications like IRIS?

Immune Reconstitution Inflammatory Syndrome (IRIS) is a potential complication in HIV/TB co-infected patients initiating antiretroviral therapy (ART). What is the underlying immunological mechanism that BEST explains the development of paradoxical TB-IRIS?

Mycobacterium ulcerans, the causative agent of Buruli ulcer, is unique among pathogenic mycobacteria due to its production of mycolactone. What is the PRIMARY role of mycolactone in the pathogenesis of Buruli ulcer?

In the treatment of Mycobacterium kansasii pulmonary disease, current guidelines recommend a fixed duration of 12 months of therapy instead of the traditional approach of 12 months beyond culture conversion. What is the PRIMARY rationale for this fixed duration approach in M. kansasii infections?

A patient is diagnosed with Mycobacterium xenopi pulmonary disease. Considering the challenges in treating this NTM species and its association with poorer outcomes, what modification to the standard NTM treatment regimen is MOST critical to consider in patients with cavitary lung disease and advanced bronchiectasis?

In the context of drug resistance in Mycobacterium tuberculosis, mutations in the rpoB gene are frequently associated with resistance to rifampin. What is the MOST direct consequence of rpoB mutations on the mechanism of action of rifampin?

For a patient with pulmonary disease caused by Mycobacterium avium complex (MAC) that is determined to be macrolide-susceptible, which of the following antibiotic classes would be considered the CORNERSTONE of the recommended multi-drug treatment regimen?

A clinical microbiology laboratory is processing a sputum sample suspected of containing mycobacteria. For a slow-growing mycobacterium, such as Mycobacterium tuberculosis or Mycobacterium avium complex, what is the MINIMUM number of days typically required for visible colony growth on solid culture media to allow for identification and drug susceptibility testing?

A patient presents with cervical lymphadenitis, and subsequent diagnostic workup reveals infection with a non-tuberculous mycobacterium. Which of the following NTM species is MOST frequently associated with cervical lymphadenitis, particularly in children?

When initiating treatment for latent tuberculosis infection (LTBI), what are the FIRST two critical steps that should be undertaken to ensure appropriate management and prevent progression to active disease?

A patient with active tuberculosis is being treated with a regimen including rifampin. They also take several other medications for chronic conditions. Which of the following drug interactions is MOST concerning due to rifampin's known pharmacological properties?

Mycobacterium ulcerans infection, or Buruli ulcer, typically manifests initially as a painless nodule on the skin. What is the MOST characteristic progression of this nodule if left untreated?

In the context of tuberculosis treatment, why is it generally contraindicated to add only a SINGLE new anti-TB drug to a failing treatment regimen where there is evidence of ongoing bacterial replication and lack of clinical improvement?

Which of the following diagnostic tests is MOST appropriate for RAPIDLY detecting rifampin resistance in Mycobacterium tuberculosis directly from a sputum sample, enabling timely adjustments to the treatment regimen?

For patients with disseminated infections caused by non-tuberculous mycobacteria (NTM), particularly in the context of advanced HIV/AIDS, which NTM species is MOST frequently identified as the causative agent?

A patient with pulmonary Mycobacterium xenopi infection also has advanced bronchiectasis and cavitary lung disease. Considering these complicating factors, what is the MOST important adjustment to the standard M. xenopi treatment regimen to optimize therapeutic outcomes?

What is the MOST significant clinical advantage of using rifabutin over rifampin in the treatment of tuberculosis for HIV-positive patients who are concurrently receiving protease inhibitors (PIs) as part of their antiretroviral therapy?

For pulmonary tuberculosis, what is generally considered the STANDARD intensive phase regimen in current daily treatment guidelines for drug-sensitive TB?

Which of the following BEST describes the phenomenon of 'persisters' in the context of mycobacterial infections and their contribution to the challenges in treatment?