Mycobacteria Overview Quiz

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Questions and Answers

What is the main cause of human tuberculosis in developed countries?

  • Mycobacterium tuberculosis (correct)
  • Non-tuberculous mycobacteria
  • Mycobacterium bovis
  • Mycobacterium marinum

Which characteristic does NOT describe Mycobacterium?

  • Spores forming (correct)
  • Non-motile
  • Aerobic
  • Very thin rods

What is the estimated percentage of infected individuals who actually develop tuberculosis?

  • 25-30%
  • 15-20% (correct)
  • 35-40%
  • 5-10%

What is a common mode of transmission for tuberculosis?

<p>Inhalation of a single viable organism (C)</p> Signup and view all the answers

What is the prevalence of tuberculosis in the Philippines?

<p>About 1 million active cases (B)</p> Signup and view all the answers

Which of these mycobacteria is associated with drug-resistant tuberculosis?

<p>Mycobacterium tuberculosis (D)</p> Signup and view all the answers

Which category does Mycobacterium bovis belong to?

<p>Mycobacterium tuberculosis complex (D)</p> Signup and view all the answers

In what state is tuberculosis particularly dangerous for immune-compromised individuals?

<p>Pulmonary phase (C)</p> Signup and view all the answers

What unique component is found in the cell wall of Mycobacterium?

<p>N-glycolyl muramic acid (C)</p> Signup and view all the answers

What characteristic makes Mycobacterium difficult to stain?

<p>High lipid content (C)</p> Signup and view all the answers

Which strain of Mycobacterium bovis is used for immunization against tuberculosis?

<p>Bacillus Calmette-Guerin (BCG) (C)</p> Signup and view all the answers

What is the property of Mycobacterium that allows them to resist decolorization with acidified alcohol?

<p>Acid Fastness (A)</p> Signup and view all the answers

What occurs after the initial infection with Mycobacterium tuberculosis?

<p>Subsequent organ involvement (B)</p> Signup and view all the answers

Which symptom is NOT commonly associated with pulmonary tuberculosis?

<p>Nausea (C)</p> Signup and view all the answers

How do Mycobacterium bacilli typically enter the body?

<p>Ingestion of infected milk (D)</p> Signup and view all the answers

What type of immune response does the BCG vaccine aim to elicit?

<p>Cell-mediated immunity (D)</p> Signup and view all the answers

What is the most likely reason some patients develop miliary tuberculosis?

<p>Poorly functioning cellular immunity (D)</p> Signup and view all the answers

What describes Mycobacterium's classification in terms of Gram staining?

<p>Generally considered gram-positive (B)</p> Signup and view all the answers

Which of the following organs can be involved in tuberculosis infection aside from the lungs?

<p>Cervical lymph nodes (D)</p> Signup and view all the answers

What immune response takes place when the body tries to eliminate Mycobacterium tuberculosis?

<p>Delayed hypersensitivity response (A), Cell-mediated immunity (B)</p> Signup and view all the answers

What is a common presenting symptom of miliary tuberculosis?

<p>Night sweats (D)</p> Signup and view all the answers

How is tuberculosis primarily diagnosed?

<p>Tuberculin test (C)</p> Signup and view all the answers

What do granulomas in the lungs primarily consist of?

<p>Macrophages and lymphocytes (C)</p> Signup and view all the answers

Which of the following is NOT a common symptom of primary active tuberculosis?

<p>Loss of taste (C)</p> Signup and view all the answers

What is a disadvantage of the PPD test for tuberculosis?

<p>It lacks 100% sensitivity and specificity (C)</p> Signup and view all the answers

What is indicated by a positive reaction to the PPD skin test?

<p>Exposure to Mycobacterium tuberculosis (B)</p> Signup and view all the answers

What does the term 'miliary' refer to in tuberculosis?

<p>Disseminated disease (A)</p> Signup and view all the answers

Which system can be affected by tuberculosis leading to meningitis?

<p>Nervous system (C)</p> Signup and view all the answers

What does tissue necrosis caused by the hypersensitivity reaction in tuberculosis result in?

<p>Low granuloma formation with caseous material (C)</p> Signup and view all the answers

How are T-cells and macrophages involved in tuberculosis infection?

<p>They help phagocytize the bacteria in the lungs (D)</p> Signup and view all the answers

What is NOT a possible outcome when Mycobacterium antigen concentration is high?

<p>Development of larger granulomas (D)</p> Signup and view all the answers

Which test simulates proteins found in M. tuberculosis for diagnostic purposes?

<p>PD test (D)</p> Signup and view all the answers

Which statement accurately describes the transmission of NTMs?

<p>NTMs are not usually transmitted from person to person. (C)</p> Signup and view all the answers

What is true regarding the isolation of NTM organisms?

<p>Isolation of NTMs may not be associated with disease. (B)</p> Signup and view all the answers

Which factor can complicate the interpretation of an NTM culture?

<p>Nodular or fibrotic changes on chest X-ray. (B)</p> Signup and view all the answers

What does recent contact with an active TB patient suggest regarding NTMs?

<p>NTMs may also be present and complicate diagnosis. (A)</p> Signup and view all the answers

What is a notable characteristic of NTMs regarding their pathogenic potential?

<p>Pathogenic potential varies greatly among different NTM species. (A)</p> Signup and view all the answers

What does the PD Test specifically assess?

<p>Responses to multiple antigens (D)</p> Signup and view all the answers

What characteristic makes the PD Test less subject to reader bias?

<p>The test can be performed in a single visit (B)</p> Signup and view all the answers

What key feature distinguishes the results of the PD Test from the effects of BCG vaccination?

<p>Results are unaffected by previous BCG vaccination (D)</p> Signup and view all the answers

What reaction is observed in an infected individual after the PD Test?

<p>Delayed hypersensitivity reaction (C)</p> Signup and view all the answers

Which of the following best describes induration measured after the PD Test?

<p>Firmness resulting from immune cell influx (C)</p> Signup and view all the answers

Approximately how many species of non-tuberculous mycobacteria (NTMs) are currently recognized?

<p>130 species (A)</p> Signup and view all the answers

What is the primary mode of transmission for Mycobacterium tuberculosis?

<p>Inhalation of infectious aerosols (D)</p> Signup and view all the answers

In which areas can non-tuberculous mycobacteria (NTMs) sometimes colonize healthy individuals?

<p>Skin, respiratory, and gastrointestinal tracts (A)</p> Signup and view all the answers

Flashcards

Tuberculosis (TB)

An airborne disease that's a leading killer among infectious diseases.

Mycobacterium tuberculosis complex

A group of bacteria causing TB, including M. tuberculosis (main culprit).

Mycobacterium tuberculosis

The primary bacteria responsible for most TB cases, especially in developed countries.

Mode of Transmission (TB)

Inhalation of the bacteria; needs close contact.

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Nontuberculous Mycobacteria (NTM)

Mycobacteria that are not part of the TB complex and often cause other infections.

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Aerobic Mycobacteria

Bacteria that require oxygen to grow, though some can survive with reduced oxygen.

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Non-spore forming bacteria

Mycobacteria don't produce spores.

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Non-motile bacteria

Mycobacteria cannot move on their own.

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N-glycolyl muramic acid

A unique component found in the cell wall of Mycobacterium, differing from the typical N-acetyl muramic acid.

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Acid-Fastness

A characteristic of Mycobacteria's cell walls that resists decolorization with acidified alcohol after staining.

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Mycobacterium

A genus of bacteria having an unusual cell structure and high lipid content.

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Lipid content

Mycobacteria have a high lipid content in their cell wall, creating a hydrophobic barrier.

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Gram-positive

Mycobacteria, while not Gram-Stained, are generally considered Gram-positive due to their resisting decolourisation

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Mycobacterium bovis

A type of mycobacterium that can cause infection after ingestion of infected milk/products

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BCG (Bacillus Calmette-Guerin)

An attenuated strain of M.bovis used as a tuberculosis vaccine.

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Intracellular Pathogen

A pathogen that lives and/or multiplies within the cells of a host.

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Tuberculosis Diagnosis

A method to diagnose tuberculosis, typically involving a skin test (tuberculin test).

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Tuberculin Test

A skin test used to diagnose tuberculosis infection..

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Mycobacterium Infection

Infection by the Mycobacterium organism, particularly M. tuberculosis.

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Granulomas

Hard tubercles formed in the lungs due to immune cells.

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Macrophages

Immune cells that try to engulf and destroy pathogens.

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Tissue Necrosis

Death of tissue due to a strong immune response.

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Delayed Hypersensitivity

An immune response that takes time to develop after exposure to a pathogen.

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PD Test

Short for PPD test, a skin test used to detect exposure to Mycobacterium tuberculosis.

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Miliary Tuberculosis

Disseminated tuberculosis, often caused by a weakened immune system, where the disease spreads through the lymphatic system or bloodstream.

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Common Symptoms of TB

Low-grade fever, night sweats, anorexia (loss of appetite), weight loss, and fatigue.

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Pulmonary TB Symptoms

Productive cough, low-grade fever, chills, myalgias (aches), and sweating.

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TB Disease Pathway

Describes the process of TB infection from initial respiratory exposure to potential organ involvement

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Extra-pulmonary TB

TB infection that affects organs outside of the lungs, such as the genitourinary tract, cervical lymph nodes, nervous system, bones, and joints.

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Tuberculin Skin Test (TST)

A diagnostic test used to detect exposure to TB bacteria. It involves injecting the purified protein derivative (PPD) under the skin.

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Symptom Similarity

Symptoms of TB resemble infections like the flu, bronchitis, and pneumonia.

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Immune System Function

A weak immune system can increase the chances of TB spreading from the lungs.

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PPD

Purified protein derivative of M. tuberculosis. It's a protein used in the skin test to identify exposure to TB bacteria.

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Delayed Hypersensitivity Reaction

A delayed immune response to M. tuberculosis resulting in redness (erythema) and firmness (induration) at the injection site, observed in TB Skin test.

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Induration

Firmness or swelling at the site of the injection in the TB skin test, a sign of an immune response.

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NTM (Nontuberculous Mycobacteria)

Mycobacterial species that are not part of the Mycobacterium tuberculosis complex (i.e., not TB).

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Mode of NTM transmission

Primarily via inhalation of infectious aerosols and ingestion, but some are iatrogenic (from medical procedures).

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Erythema

Redness at the injection site, a sign of a hypersensitivity reaction in the TB skin test.

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Diagnosis of TB infection

Diagnosis based on the diameter of induration as measured in the skin test site.

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NTM Transmission

Nontuberculous Mycobacteria (NTM) are typically NOT spread from person to person, unlike Mycobacterium tuberculosis (MTB).

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NTM Isolation Significance

Finding NTM in a sample doesn't always mean infection. It's common in the environment and some species are harmless.

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Positive NTM Culture - Complicated

Interpreting a positive NTM culture is tricky. It depends on factors like patient health, exposure, and NTM species.

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Tuberculin Test - Positive

A positive tuberculin test (≥ 5mm) is significant in: HIV patients, recent TB contact, nodular chest X-ray, and organ transplant recipients.

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Tuberculin Test - Interpretation (≥10mm)

A positive tuberculin test (≥ 10 mm) is generally significant in individuals with no known risk factors for TB.

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Study Notes

Mycobacteria

  • Tuberculosis is a highly curable but prevalent disease.
  • It's the leading killer among infectious diseases in the Philippines.
  • Many drug-resistant cases exist.
  • Mycobacterium belong to a genus of aerobic, non-spore-forming, non-motile microorganisms.
  • They are rod-shaped (0.2-0.6 μm x 1-10 μm) and may branch.
  • Cell walls contain unusual N-glycolyl muramic acid (instead of N-acetyl).
  • High lipid content creates a hydrophobic permeability barrier.
  • Acid-fastness is a crucial property of mycobacteria, not usually stained by gram staining.
  • Gram positive
  • Mycobacteria generally grow slower than most human pathogens (20-36 hours for division).
  • Colonies form visibly in 2-60 days.

Major Groups of Mycobacteria

  • Mycobacteria are divided into two groups, based on differences in epidemiology and disease association.
  • Mycobacterium tuberculosis complex: includes M. tuberculosis, M. caprae, M. bovis, M. microti, M. bovis BCG, and M. canettii, M. africanum, and M. pinnipedii.
  • Nontuberculous mycobacteria (NTM): all species not in the complex.

Mycobacterium tuberculosis Complex

  • Pathogenesis (M. tuberculosis): inhalation of a viable organism often leads to infection. The disease usually develops years later due to immune system breakdown.
  • In some, infection becomes systemic and affects multiple organs.
  • Pathogenesis (M. bovis): ingestion of infected cow's milk can lead to infection, and the M. bovis strain BCG is used for vaccination.
  • BCG: attenuated strain of M. bovis, is used to immunize against tuberculosis.

Signs and Symptoms of Tuberculosis

  • Symptoms can vary from asymptomatic to acutely symptomatic, often include lung-related signs or symptoms.
  • General common presenting symptoms of pulmonary tuberculosis include low-grade fever, night sweats, fatigue, loss of appetite, and weight loss.

Diagnosis of Tuberculosis

  • Tuberculin test (PPD): measures delayed hypersensitivity to tuberculin and is often used to diagnose TB infection; however not 100% accurate.
  • QuantiFERON-TB Gold: new test approved by the FDA to diagnose latent or current TB infection.

Nontuberculous Mycobacteria (NTM)

  • 130 recognized species.
  • Ubiquitous in the environment.
  • Infections are rarely transmitted person-to-person.
  • 1959, Runyon's system classifies them into four groups (I-IV) based on growth characteristics and pigment production.
  • Runyon group I (Photochromogens): require light for pigmentation.
  • Runyon group II (Scotochromogens): produce pigment in the dark.
  • Runyon group III (Nonphotochromogens): do not produce pigment under any condition.
  • Runyon group IV (Rapid growers): exhibit rapid growth(visible in less than 7 days).

Other Relevant Topics

  • Miliary (disseminated) tuberculosis occurs when infection spreads via the lymphatic system or bloodstream.
  • Other organ involvement, such as the genitourinary tract, cervical lymph nodes, and nervous system, can be affected in some cases.
  • Tuberculosis may mimic other conditions, including pneumonia, neoplasms, or fungal infections.

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