A fellow student asks you to explain how tuberculosis (TB) can remain dormant in some people. What explanation will you give?
It does not remain dormant but some host defenses can kill the bacteria
Virulence factors in the baciilli weaken over time leading to apoptosis
The bacilli can become isolated within tubercles in the lungs, possibly encapsulated
Macrophages attack and phagocytize new areas of infection
The Correct Answer is C
A. It does not remain dormant but some host defenses can kill the bacteria: While the immune system can kill some of the Mycobacterium tuberculosis bacilli, in many cases, the bacteria evade complete eradication and persist in a dormant state within the lungs. This does not mean the infection is fully eliminated, as it can reactivate later.
B. Virulence factors in the bacilli weaken over time, leading to apoptosis: Mycobacterium tuberculosis does not naturally lose its virulence over time. Instead, it can persist in a latent state due to immune containment, not because of a reduction in its ability to cause disease.
C. The bacilli can become isolated within tubercles in the lungs, possibly encapsulated: In latent tuberculosis, the immune system walls off the bacilli within granulomas (tubercles), preventing active disease. These granulomas may be encapsulated with fibrous tissue, restricting bacterial growth and spread. The bacteria remain dormant but can reactivate if the immune system weakens.
D. Macrophages attack and phagocytize new areas of infection: While macrophages do play a role in the immune response to tuberculosis, they are often unable to completely eradicate the bacilli. Instead, the bacteria can survive within macrophages and trigger the formation of granulomas, which help contain but not eliminate the infection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Bradycardia: Bradycardia, which is a slower than normal heart rate, is not a typical clinical manifestation of pleural effusion with empyema. In fact, fever and infection usually lead to tachycardia (an increased heart rate) as the body attempts to respond to infection.
B. Pleural pain: Pleural pain is a common symptom associated with pleural effusion and empyema, resulting from irritation of the pleura due to inflammation or infection.
C. Cough: A cough can occur with pleural effusion and empyema, often as a response to irritation or pressure in the thoracic cavity. It may also be associated with underlying lung conditions contributing to the effusion.
D. Fever: Fever is a typical clinical manifestation of empyema, indicating an infectious process. The presence of infection in the pleural space often results in systemic signs of infection, such as fever.
Correct Answer is A
Explanation
A. Carotid wall thinness: Carotid wall thinness is not considered a nontraditional risk factor for coronary artery disease (CAD). Traditional risk factors for CAD include age, gender, hypertension, hyperlipidemia, and smoking, while carotid wall thickness (rather than thinness) is often used as a marker for atherosclerosis and cardiovascular risk.
B. Chronic kidney disease: Chronic kidney disease (CKD) is recognized as a nontraditional risk factor for coronary artery disease. It is associated with increased cardiovascular risk due to factors like inflammation, mineral metabolism disorders, and increased vascular stiffness.
C. Coronary artery calcification: Coronary artery calcification is considered a nontraditional risk factor for CAD. It reflects the presence of atherosclerosis and is associated with an increased risk of cardiovascular events.
D. Markers of inflammation, ischemia, and thrombosis: Markers of inflammation (such as C-reactive protein), ischemia, and thrombosis (such as fibrinogen and D-dimer) are nontraditional risk factors for coronary artery disease. Elevated levels of these markers indicate increased cardiovascular risk and are used in risk stratification.
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