Pulmonology · TB microbiology, pathogenesis, diagnosis, treatment; endemic mycoses; opportunistic fungal syndromes
By completing this question set, you will be able to describe M. tuberculosis microbiology (acid-fast, obligate aerobe, intracellular pathogen) and explain why cell-mediated immunity is critical for containment. You will distinguish primary TB (Ghon complex, middle/lower lobe, usually contained → LTBI) from reactivation TB (apical cavitary, highly infectious, risk factor–driven). You will interpret PPD and IGRA results using risk-stratified cutoffs and explain the advantage of IGRA over PPD in BCG-vaccinated populations. You will apply the RIPE regimen structure, explain the rationale for multi-drug therapy and DOT, define MDR and XDR TB, and make clinical treatment decisions for special populations (HIV co-infection, pregnancy). You will identify the four major endemic mycoses (Histoplasma, Coccidioides, Blastomyces, Paracoccidioides) by their geographic distribution, exposure history, and pathognomonic histologic features. You will describe aspergilloma as a saprophytic complication of pre-existing cavities and distinguish it from invasive aspergillosis. You will identify Cryptococcus from its capsule features and clinical context.