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. Hospital-acquired pneumonia: Pneumonia that develops 48 hours or more after hospital admission is classified as hospital-acquired pneumonia (HAP). It is caused by pathogens acquired in the hospital setting, often involving multidrug-resistant organisms such as Pseudomonas aeruginosa, Staphylococcus aureus (including MRSA), and Klebsiella pneumoniae. Patients who are intubated, have prolonged hospital stays, or have weakened immune defenses are at higher risk.
B. Immunocompromised pneumonia: Pneumonia in immunocompromised patients occurs due to weakened host defenses, such as in individuals with HIV/AIDS, those undergoing chemotherapy, or transplant recipients on immunosuppressive therapy. While these patients can develop HAP, pneumonia due to opportunistic infections like Pneumocystis jirovecii or fungal infections is categorized separately.
C. Community-acquired pneumonia: Pneumonia acquired outside the hospital or within the first 48 hours of admission is classified as community-acquired pneumonia (CAP). Typical pathogens include Streptococcus pneumoniae, Haemophilus influenzae, and Mycoplasma pneumoniae. CAP is usually less resistant to antibiotics compared to HAP.
D. Viral pneumonia: Pneumonia caused by viral pathogens such as influenza, respiratory syncytial virus (RSV), or SARS-CoV-2 is classified based on the causative agent rather than the setting in which it was acquired. Although viruses can cause both CAP and HAP, the classification of pneumonia is determined by the timing of onset and exposure risks.
Correct Answer is B
Explanation
A. Acute pericarditis: Acute pericarditis is characterized by inflammation of the pericardium, often presenting with pleuritic chest pain, pericardial friction rub, and diffuse ST-segment elevations on ECG. It does not typically involve pericardial thickening or chronic symptoms such as pitting edema and dyspnea on exertion.
B. Constrictive pericarditis: Chronic pericarditis with pericardial thickening suggests constrictive pericarditis, a condition where the pericardium becomes rigid and fibrotic, impairing diastolic filling and leading to heart failure symptoms such as peripheral edema, crackles in the lungs, and dyspnea on exertion. The echocardiogram findings confirm this diagnosis.
C. Pericardial effusion: Pericardial effusion refers to the accumulation of excess fluid in the pericardial sac, which can lead to cardiac tamponade if severe. However, the presence of pericardial thickening rather than fluid accumulation suggests constrictive pericarditis rather than an isolated effusion.
D. Effusion-constrictive pericarditis: This condition involves both pericardial effusion and constrictive pericarditis. While it may share some features with constrictive pericarditis, the case description primarily highlights pericardial thickening rather than significant effusion, making constrictive pericarditis the more accurate diagnosis.
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