case6anki Flashcards
1
Q
Front
A
Back
2
Q
What antigen is found in the urine for TB detection?
A
LAM
3
Q
How is TB detected using a dipstix test?
A
By detecting the TB antigen in urine
4
Q
In which patients is the dipstix test for TB useful?
A
Patients with advanced HIV infection
5
Q
Does a negative dipstix test for TB rule out TB?
A
No, a negative result does not rule out TB
6
Q
What is the duration of the intensive phase of TB treatment?
A
2 months
7
Q
Which drugs are used in the continuation phase of TB treatment?
A
Rifampicin and isoniazid
8
Q
How often does M. tuberculosis divide?
A
Every 20 hours
9
Q
How often does E. coli divide?
A
Every 20 minutes
10
Q
Why is the duration of TB therapy long?
A
Because TB bacilli become dormant and difficult to eradicate
11
Q
What is multidrug therapy used for?
A
To prevent drug resistant strains
12
Q
What must a drug be able to do to work against bacteria?
A
Penetrate the bacterial cell wall
13
Q
Is the cell wall of M. tuberculosis simple or complex?
A
Complex
14
Q
What is the mechanism of action of isoniazid?
A
Inhibits mycolic acid synthesis
15
Q
What are the side effects of isoniazid?
A
Vitamin B6 deficiency, peripheral neuropathy, and hepatitis
16
Q
What is isoniazid often administered with?
A
Pyridoxine
17
Q
Does isoniazid penetrate tissues well?
A
Yes
18
Q
How is rifampicin metabolized?
A
By acetylation
19
Q
What color does rifampicin turn urine?
A
Orange
20
Q
What is rifampicin’s bioavailability?
A
Variable
21
Q
What does rifampicin induce?
A
Metabolism by activating nuclear pregnane X receptor
22
Q
What is the mechanism of action of pyrazinamide?
A
Inhibits mycobacterial fatty acid synthase
23
Q
What are the side effects of pyrazinamide?
A
Hepatitis, gout, and hypersensitivity
24
Q
Does pyrazinamide penetrate tissues well?
A
Yes
25
At what pH does pyrazinamide work well?
Low pH
26
What is the mechanism of action of ethambutol?
Inhibits arabinogalactan synthesis
27
What are the side effects of ethambutol?
Retrobulbar neuritis (optic neuritis)
28
Does ethambutol penetrate the CNS well?
No
29
What are the second-line drugs used for drug-resistant TB?
Fluoroquinolones, bedaquiline, linezolid, and clofazimine
30
What does MDR stand for in drug-resistant TB?
Multiple Drug Resistance
31
What does XDR stand for in drug-resistant TB?
Extensively Drug Resistance
32
How is INH resistance treated?
With rifampicin, ethambutol, pyrazinamide, and levofloxacin
33
What happens during progressive pulmonary TB?
Infection progresses with liquefaction of contents, leading to cavities
34
What is tuberculous bronchopneumonia characterized by?
Dissemination of multiple caseous foci around bronchi
35
What is the term used to describe tuberculous lobar pneumonia?
A pyramidal/wedge-shaped lesion with a base on the pleura
36
How does tuberculous infection disseminate hematogenously?
Through the drainage of mediastinal lymph nodes via the thoracic duct into the subclavian vein
37
What is the definition of pneumonia?
Pneumonia is an infection of lung parenchyma causing alveolar inflammation in one or more lobes of one or both lungs.
38
What are the risk factors for pneumonia?
The risk factors for pneumonia include age 65 years old, chronic lung diseases, immunosuppression, viral respiratory tract infections, institutionalization, smoking, and alcoholism.
39
How can pneumonia spread?
Pneumonia can spread through respiratory transmission from host to host or through hematogenous spread from another infection with the same pathogen.
40
What are the causative organisms of pneumonia?
The causative organisms of pneumonia include S. pneumoniae, Influenza virus, S. aureus, RSV, H. influenza, Parainfluenza, Group A streptococci, Pseudomonas aeruginosa, Anaerobes.
41
What are the different classifications of pneumonia?
The classifications of pneumonia include HAP (hospital-acquired pneumonia), VAP (ventilator-associated pneumonia), HCAP (healthcare-associated pneumonia), CAP (community-acquired pneumonia), and aspiration pneumonia.
42
What are the signs and symptoms of pneumonia?
The signs and symptoms of pneumonia include high fever, dyspnea, cough, muscle pain, haemoptysis, fatigue, pleuritic chest pain, crepitation on palpation, tachypnoea, tachycardia, wheezing, and dullness on percussion.
43
What are the diagnostic methods for pneumonia?
The diagnostic methods for pneumonia include CXR (consolidation and pleural effusion), crackles and wheezing on auscultation, blood cultures (not routine), serology for atypical organisms, PCR for viruses, TB, and Bordetella pertussis, and expectorated sputum MC&S.
44
What is the antimicrobial therapy for CAP?
The antimicrobial therapy for CAP includes oral lactam (e.g. amoxicillin) for outpatients, IV lactam (ampicillin) for inpatients, amoxicillin clavulanate or a 2nd or 3rd generation cephalosporin PLUS macrolide for severe inpatients, and moxifloxacin or levofloxacin for B lactam allergy.
45
How can pneumonia be prevented?
Pneumonia can be prevented by vaccinating children with pneumococcal conjugate vaccine, H. influenzae type b conjugate vaccine, influenza and measles vaccines, vaccinating adults over 65 with S. pneumoniae polysaccharide vaccine, and administering influenza vaccine to all, especially those over 65 and pregnant women. Cough and hand hygiene also play a role in prevention.
46
What are the defense mechanisms against pneumonia?
The defense mechanisms against pneumonia include sharp branching of airways (anatomy), cough reflex, mucous that prevents micro-organism attachments, and ciliary action.
47
What is the pathogenesis of pneumonia?
The pathogenesis of pneumonia involves acute congestion, red hepatisation, grey hepatisation, and resolution stages.
48
What are the complications of pneumonia?
The complications of pneumonia include meningitis, empyema, sepsis, lung abscess, pleural effusions, and bronchiectasis.
49
What is the difference between typical and atypical pneumonia?
Typical pneumonia is normally caused by bacteria like S. pneumoniae and occurs in very young and old people, while atypical pneumonia is caused by viruses like influenza virus or other microorganisms and affects young adults.
50
What are the pathogenesis routes for bacterial pneumonia?
Bacterial pneumonia can occur through microaspiration from the nasopharynx (S. pneumoniae), inhalation (S. pneumoniae, TB, viruses, legionella), aspiration (anaerobes), or bloodborne transmission (S. endocarditic, septic emboli).
51
What are the pathogens commonly found in aspiration pneumonia?
In aspiration pneumonia, mixed flora and mouth anaerobes are commonly present as pathogens.
52
What cell types are found in the sinus region of lymph nodes?
Dendritic cells
53
Which cell types are found in the cortex of lymph nodes?
B cells, Macrophages, Dendritic cells, Follicular dendritic cells
54
What cell types reside in the paracortex of lymph nodes?
T cells, Macrophages, Dendritic Cells, High endothelial venules
55
Which structures are present in the medulla of lymph nodes?
Medullary cords and Medullary sinuses
56
What are the primary follicles in lymph nodes?
Nonactive follicles
57
What characterizes secondary follicles in lymph nodes?
Germinal centres and the presence of follicular dendritic cells, macrophages, and mitotic and developing B cells
58
Which B cells are found in the mantle zone of secondary lymphoid follicles?
B cells not specific for antigen
59
What cell types are present in the germinal center of secondary lymphoid follicles?
Follicular dendritic cells, macrophages, and mitotic and developing B cells
60
What process occurs in the dark zone of secondary lymphoid follicles?
Antigen activation of B cells leading to differentiation and clonal expansion
61
What are the functions of the Thymus Gland?
Maturation and proliferation of T cells, development of self-tolerance, hormone secretion, and haematopoiesis in fetal development
62
What happens to double negative T-cells in T cell differentiation?
They proliferate and mature into double positive T-cells
63
Which MHC molecules are recognized by CD4 and CD8 T-cells, respectively?
CD4 requires MHC II and CD8 requires MHC I
64
What happens to T cells that recognise self MHC and self-antigens?
They undergo apoptosis
65
What are the components of the Thymus Gland cortex?
Blood vessels, Maturing T-cells, Thymic epithelial cells, Immature T-cells derived from bone marrow, and Differentiating T-cells
66
What are the two distinct components of Thymic Medulla?
Hassal’s corpuscles and Thymic epithelial cells
67
What is the function of Thymic Epitheliocytes?
They act as 'nurse cells' promoting T-cell maturation and clonal selection, and induce apoptotic death in self-reactive T-cells
68
What are the functions of the Spleen?
Mount immune response to blood-borne antigens, filter articles and old/defective blood cells, and participate in haematopoiesis in fetal development
69
Describe the structure of the Spleen.
Support tissue with fibrocollagenous capsule, red pulp consisting of blood-filled sinuses and splenic chords, white pulp with arborizing arteries surrounded by lymphoid tissue
70
What is the purpose of blood filtration in the red pulp of the Spleen?
To remove debris; blood flows from central artery to pencillary arteries, sheathed capillaries, splenic cords, and eventually splenic sinuses/veins
71
How does the interaction with antigen occur in the white pulp of the Spleen?
Blood passes through central and radial arterioles into marginal sinuses, where there is extensive contact with antigen-presenting cells (APCs)
72
What does MALT/GALT stand for?
Mucosa/Gut-associated lymphoid tissue
73
What is the function of MALT/GALT?
Surveillance of antigen in gut, urogenital and respiratory tract
74
Name some examples of MALT tissues.
Waldeyer’s Ring (tonsils/adenoids), Peyer’s Patches, and Appendix GALT
75
What are the virulence factors of tuberculosis?
Bacteria inhibits phago-lysosomal function and secretes anti-oxidants and proteins that induce membrane rupture.
76
How can bacteria escape in tuberculosis?
Bacteria can escape and enter blood vessels, establishing niches in other body sites.
77
What is the role of dendritic cells in the adaptive immune response?
Dendritic cells present antigens on MHC II and stimulate CD4 T cell activation.
78
What happens when Th1 cell response is stimulated in tuberculosis?
A Th1 cell response is stimulated, leading to the activation of CD4 T cells.
79
What causes bronchiectasis?
Bronchiectasis is caused by chronic inflammation due to mucous accumulation in the airways.
80
What are the aetiological factors of bronchiectasis?
Infections, obstructions, and impaired defence are aetiological factors of bronchiectasis.
81
What is the distribution pattern of bronchiectasis?
Post-infective bronchiectasis is found in basal regions, while cystic fibrosis bronchiectasis is generalised.
82
What are the two main pathogenetic mechanisms in bronchiectasis?
Infection and obstruction are the two main pathogenetic mechanisms in bronchiectasis.
83
How does Kartagener's syndrome contribute to bronchiectasis?
Ciliary dyskinesia in Kartagener's syndrome causes abnormal movement of cilia, leading to mucous accumulation and chronic inflammation.
84
What is the pathogenesis of bronchiectasis in cystic fibrosis?
The stickiness of mucous leads to its accumulation, allowing bacterial proliferation and chronic inflammation.
85
What are the signs and symptoms of bronchiectasis?
Wheezing, haemoptysis, productive cough, pneumonia, foul-smelling mucous, and basilar crackles are some of the signs and symptoms of bronchiectasis.
86
How can bronchiectasis be diagnosed?
Bronchiectasis can be diagnosed using CT scan, genetic testing, CXR, spirometry, and sputum culture.
87
What are the possible complications of bronchiectasis?
Possible complications include lung abscesses, empyema abscesses, cor pulmonale, and generalised amyloidosis.
88
What are the morphological features of bronchiectasis?
Bronchiectasis is characterized by dilated airways filled with exudate, destruction of bronchial walls, bronchial wall thickening, and hypertrophy of bronchial arteries.
89
What is empyema?
Empyema is the collection of purulent exudate or pus in the pleural space.
90
What are the aetiological factors of empyema?
Direct spread of infection, such as pneumonia, abscesses, or bronchiectasis, can cause empyema.
91
What is the shape of Mycobacterium tuberculosis bacteria?
Curved rod shaped
92
Why are Mycobacterium tuberculosis bacteria impervious to gram staining?
Due to waxy cell walls composed of fatty acids
93
What are the three types of Tuberculosis?
Primary Tuberculosis, Secondary/Reactivation Tuberculosis, Extrapulmonary Tuberculosis
94
What are the risk factors for Tuberculosis?
Immunocompromised states, substance abuse, contact with active TB patients, low SES
95
How is Tuberculosis transmitted?
By inhaling infectious aerosol droplets from an individual with active TB
96
What happens when Tuberculosis enters the lungs?
It gets phagocytosed by macrophages
97
What is formed when TB infiltrated macrophages fuse with Langhans giant cells?
Granuloma
98
What is the name of the primary infection site in Tuberculosis?
Ghon focus
99
What is the name of the primary infection site along with the involved lymph node in Tuberculosis?
Ghon complex
100
What happens during primary infection resolution in Tuberculosis?
Mycobacteria are killed by the immune system and walled off in granuloma
101
What happens if the immune system is compromised during primary infection in Tuberculosis?
More caseous necrosis areas and cavity formation
102
What are the complications of Tuberculosis?
Progressive primary pulmonary tuberculosis, tuberculous lobar pneumonia, tuberculous bronchopneumonia, pneumothorax, haematogenous dissemination, organ tuberculosis
103
What are the signs and symptoms of primary tuberculosis?
Usually asymptomatic, mild flu-like illness, rarely pleural effusion
104
What are the signs and symptoms of reactivation tuberculosis?
Systemic symptoms, cough, crepitations during lung auscultation
105
What are the signs and symptoms of extrapulmonary tuberculosis?
Depends on the affected organ/tissue
106
What are the signs and symptoms of miliary (disseminated) tuberculosis?
Weight loss, fever, chills, dyspnea
107
What are the diagnostic methods for Tuberculosis?
Medical history and physical exam, CXR, tuberculin skin test, sputum smear microscopy, bacteriological culture, Xpert MTB/RIF
108
What is the purpose of sputum smear microscopy in Tuberculosis diagnosis?
To detect acid-fast staining of Mycobacterium tuberculosis
109
What is the most sensitive diagnostic method for Tuberculosis?
Bacteriological culture
110
What does Xpert MTB/RIF detect in Tuberculosis diagnosis?
TB presence and resistance to rifampicin
111
What is haematogenous spread?
Haematogenous spread is the spread of infection through the bloodstream.
112
What are the possible complications of a lung abscess?
The possible complications of a lung abscess include pleural space filled with pus, lung compression, bronchopleural fistula, and organization and thick adhesions with obliterated cavities.
113
What is the difference between a lung abscess and bronchiectasis?
In lung abscesses, several airways communicate, while in bronchiectasis, dilated airways communicate only at their normal branching points.
114
What are the primary locations affected by a primary lung abscess?
A primary lung abscess affects the dependent parts of the lungs, commonly the right side.
115
What conditions predispose an individual to aspiration?
Conditions that predispose an individual to aspiration include alcoholic stupor, head injury/loss of consciousness, impaired cough reflex, oesophageal dysfunction or dysphagia, generalised anaesthesia, and poor dental hygiene.
116
What are the complications of a primary lung abscess?
The complications of a primary lung abscess include empyema, bronchopleural fistula, pyopneumothorax, haemorrhage with haemoptysis, tension cysts or pneumatoceles, secondary amyloidosis, and meningitis or cerebral abscess.
117
What infections are associated with secondary lung abscess?
Secondary lung abscess can be associated with pneumococcal pneumonia, post-staphylococcal infection, Klebsiella, anaerobic bacteria, and extrapulmonary abscess.
118
What are the causes of pulmonary hypoplasia?
Pulmonary hypoplasia can be caused by oligohydramnios, intrathoracic masses, deformities of thorax/neuromuscular abnormalities, large vessel abnormalities, chronic amniotic fluid leak, and renal and upper respiratory tract anomalies.
119
What is congenital diaphragmatic hernia?
Congenital diaphragmatic hernia is caused by an opening in the diaphragm, often due to failure of the formation of pleuroperitoneal membranes, which allows abdominal organs to pass into the thoracic cavity.
120
What is pulmonary sequestration?
Pulmonary sequestration is a condition where a portion of the lung does not have correct anatomical, bronchial, or vascular connections and is supplied by anomalous systemic arteries.
121
What are the types of congenital cysts in the lungs?
Congenital cysts in the lungs can be bronchial or bronchogenic cysts, lined with bronchial epithelium, or enteric or enterogenous cysts, derived from the foregut and lined by gastric or intestinal epithelium.
122
What is congenital cystic adenomatoid malformation?
Congenital cystic adenomatoid malformation is a rare abnormality of lung development characterized by diffuse hamartoma, malformation of the airways, and enlargement of one lobe with small cysts.
123
What are the potential complications of congenital cystic adenomatoid malformation?
Congenital cystic adenomatoid malformation can cause compression of the lung leading to pulmonary hypoplasia, respiratory distress, and recurrent chest infections.
124
What are some common causes of primary lung cancer?
Smoking, radon, asbestos, polycyclic hydrocarbons, dietary factors, chromates, HPV, arsenic
125
What is the pathogenesis of squamous cell carcinoma of the lung?
Smoking and pollutants cause squamous metaplasia of bronchial epithelium, leading to dysplasia and progression to squamous cell carcinoma in-situ and invasive squamous carcinoma
126
What are the clinical features of pulmonary cancer?
Weight loss, cough, haemoptysis, dyspnoea, clubbing, metastases to lymph nodes, bone, brain, liver and adrenals
127
What are some methods for diagnosing pulmonary cancer?
CXR, bronchial biopsy, sputum cytology, pleural aspiration, fine needle aspiration, pleural biopsy
128
What is the design of an RCT study?
An RCT study examines the effectiveness of an intervention and features randomization, control, and manipulation
129
What is the PICO approach in an RCT study?
PICO stands for Population, Intervention, Comparison, Outcome and is used to formulate research questions in evidence-based medicine
130
What is selection bias in an RCT study?
Selection bias occurs when participants are not selected randomly, but randomization can alleviate this
131
What is performance bias in an RCT study?
Performance bias occurs when the experimental and control groups are treated differently by the researchers
132
What is attrition bias in an RCT study?
Attrition bias occurs when there is loss to follow-up, withdrawals, or changes in protocol
133
What is detection bias in an RCT study?
Detection bias occurs when participants and researchers are aware of the group allocations, leading to biased reporting of outcomes
134
What is blinding in an RCT study and how does it reduce bias?
Blinding reduces bias by masking participants, researchers, and outcome assessors to the group allocations
135
What are some strengths of an RCT study?
Randomization prevents confounding and selection bias, and it identifies cause-and-effect relationships through exposure preceding outcome
136
What are some limitations of an RCT study?
Ethical constraints, loss to follow-up, complexity, expense, time-consuming nature, and potential lack of generalizability
137
What are some statistical measures used in an RCT study?
Incidence, risk rate/ratio, number needed to treat (NNT), and risk/rate difference
138
What is the purpose of surveillance?
To detect epidemics, help eradicate disease, estimate the magnitude of a problem, detect new health problems, evaluate prevention and control activities, facilitate research, and plan effectively and allocate resources.
139
What are the key features of surveillance?
Ongoing, systematic and organized, often legislated, timely data dissemination, leading to prevention and control actions
140
What are notifiable diseases in surveillance?
Notifiable diseases are certain diseases which spread quickly and require detection for timely control measures
141
What is the consequence of rupture of caseous material into a blood vessel?
Widespread involvement of the lung (artery) or dissemination throughout the body (vein)
142
What is the term for TB bacilli carried to areas of high oxygen concentration in the lungs?
Seeding through the thoracic duct
143
What is the name given to small tubercles scattered throughout the body?
Miliary Tuberculosis
144
What is the characteristic microscopic appearance of each military tubercle?
A single granuloma with caseation
145
What are the two types of miliary TB?
Pulmonary miliary TB and extrapulmonary/organ military TB
146
What is the term for TB involvement resulting from hematogenous dissemination?
Organ Tuberculosis
147
What is the primary site of TB in organ tuberculosis?
The organ or organ system itself
148
What is the term for reactivation of dormant TB from previous infection?
Secondary Tuberculosis
149
What are the causes of secondary tuberculosis?
Reinfection or reactivation due to decreased immunity or overwhelming infection
150
What are the outcomes of secondary TB?
Healing and fibrosis, local pulmonary spread, cavities formation, spread to pleura
151
What are the three layers of active cavities in progressive fibrocaseous disease?
Inner caseous tissue, middle zone of granulomatous inflammation and granulation tissue, outer fibrous layer
152
What can occur if blood vessels become occluded in TB cavities?
Endarteritis obliterans or Rasmussen’s aneurysms
153
What are some potential sites of TB spread through hematogenous route?
Bone, adrenal glands, kidneys, fallopian tubes
154
What are the different routes of TB spread?
Haematogenous spread, direct spread, lymphatic spread, transcoelomic spread
155
What are the potential pleural involvements in TB?
TB pleuritis/pleurisy, TB effusion (TB empyema), obliterative fibrous pleuritic/pleurisy, bronchopleural fistula
156
How does pericardial involvement in TB occur?
Results from direct spread from adjacent pulmonary TB or direct spread from adjacent TB lymph nodes
157
What are some potential peritoneal involvements in TB?
TB ascites
158
What is nodal tuberculosis a result of?
Hematogenous or lymphatic spread
159
What are the causes of viral pneumonia?
Influenza, Adenovirus, Varicella, Herpes Simplex, RSV, and Measles.
160
What is the pathology of viral pneumonia?
It depends on the type of virus. Influenza, Adenovirus, Varicella, and Herpes Simplex are cytopathic, while RSV and Measles stimulate proliferative activity.
161
Which part of the respiratory system is attacked by Adenovirus in viral pneumonia?
Adenovirus attacks the bronchioles, and viral inclusions may be found.
162
What is a common feature of Adenovirus infection in viral pneumonia?
A common feature is alveolar epithelial necrosis causing hyaline membrane formation.
163
What are some diagnostic methods for viral pneumonia?
Culture, rising titre of specific antibodies, monoclonal antibodies, and electron microscopy.
164
What are the pulmonary manifestations of Varicella?
Pulmonary manifestations occur in adults.
165
What is lipoid pneumonia?
Pneumonia due to lipids entering the bronchial tree.
166
How can exogenous lipids enter the respiratory tract?
Inhaled nose drops with an oil base or accidental inhalation of cosmetic oil.
167
Which individuals are at risk of developing lipoid pneumonia?
The elderly, the developmentally delayed, and people with gastroesophageal reflux.
168
Where do B lymphocytes mature?
B lymphocytes mature in the bone marrow.
169
What is the function of the thymus gland?
The thymus gland is the site of T lymphocyte maturation.
170
What are the functions of lymph nodes?
Filtration of lymph, interaction of T-cells with antigen, aggregation and proliferation of lymphocytes, and activation of lymphocytes.
171
What are the primary lymphoid tissues?
Bone marrow and thymus gland.
172
What are the functions of lymphoid tissue?
Lymphocyte production/proliferation, lymphocyte differentiation, and lymphocyte interaction with antigens.
173
What are the protective mechanisms of the mucosal surface in airways?
Mucociliary escalator, antimicrobial enzymes, antiproteases, and surfactant proteins.
174
Which cells are present in the lamina propria of airways?
Macrophages, B and T cells, and plasma cells.
175
What are the two main types of bacteria commonly associated with pneumonia?
Peptostreptococcus spp and Actinomyces spp.
176
What are the three main methods of infection for pneumonia?
Inhalation, aspiration, and haematogenous spread
177
What are the conditions required for infection to occur in pneumonia?
Impairment of host defenses, sufficient inoculum, and highly virulent organisms
178
What are the diagnostic methods for identifying bacterial pneumonia?
Chest X-ray, sputum gram stain and culture, blood culture, arterial blood gas urea, and electrolytes
179
What is the most common cause of lobar pneumonia?
Streptococcus pneumoniae
180
What is the role of the capsule in pneumococcal pneumonia?
It prevents phagocytosis in the absence of specific antibody
181
What are the macroscopic changes observed in lobular/bronchopneumonia?
Patchy areas of red or grey consolidation
182
What are the microscopic changes observed in lobular/bronchopneumonia?
Acute bronchiolitis, neutrophil infiltration in bronchi and bronchioles, and thickening of alveolar septa
183
What are the predisposing factors for lobular/bronchopneumonia?
Previous acute infections, chronic lung diseases, aspiration of substances, obstructed bronchus, post-surgery, and carcinoma
184
What are the characteristics of lobar pneumonia?
Diffuse fibrinosuppurative consolidation of a large portion or an entire lobe, limited spread, and four stages of inflammatory response - congestion, red hepatisation, grey hepatisation, and resolution
185
What is tuberculosis (TB) pneumonia?
It is a chronic specific inflammatory disease caused by Mycobacterium tuberculosis that commonly affects the lungs and can also attack other organs
186
How does HIV coinfection affect TB pneumonia?
It accelerates disease progression and is the most important risk factor for TB as it prevents initial infection containment
187
What is the commonest viral cause of pneumonia in adults?
Influenza A and B
188
Which virus is most commonly seen in children with pneumonia?
Respiratory syncytial virus (RSV)
189
Which group of people are more susceptible to viral pneumonia?
Children and adults
190
What is the order of lymph node infection frequency in tuberculosis?
cervical > inguinal > axillary
191
What is the primary cause of gastrointestinal TB?
Mycobacterium bovis from unpasteurized milk in infected cows
192
What are the two types of TB in the gastrointestinal tract?
Primary TB and Secondary TB
193
Which part of the gastrointestinal tract does TB normally involve?
Terminal ilium
194
What is the observed healing process in gastrointestinal TB?
Extensive healing by fibrosis leading to stricture formation
195
How can renal involvement occur in TB?
Haematogenous spread or secondary involvement by glomerulonephritis or amyloidosis
196
Which part of the genital tract does TB primarily affect?
Epididymis and testis
197
What complications can occur in the genital tract due to TB?
Infertility
198
How can TB present in the skin?
Tuberculous chancre, warty lupus, orificial ulcers, papulonecrotic tuberculids, lupus vulgaris, scrofuloderma, tuberculous gumma, or military TB
199
What are the two main types of CNS tuberculosis?
Tuberculous meningitis and tuberculous meningocephalitis
200
What is the role of macrophages in the innate immune response against TB?
Ingest bacilli, recognize via PRRs, and facilitate phagocytosis
201
What is the purpose of granuloma formation in the immune response against TB?
Organize immune cells and enhance mycobacterium killing mechanisms
202
What are the reasons for reporting diseases?
Diseases that are prone to epidemics, can be controlled or prevented, and diseases that spread from animals to humans (zoonosis) must be reported.
203
What are the types of surveillance?
Passive, active, and sentinel.
204
What is passive surveillance?
It involves standardized reporting by health care workers of notifiable medical conditions.
205
What is active surveillance?
It involves an ongoing search for cases.
206
What is sentinel surveillance?
It observes a sample, which can be accurate and representative but less expensive.
207
What factors should be considered in the design of surveillance systems?
Simplicity, flexibility, data quality, acceptability, sensitivity, positive predictive value, timeliness, representativeness, and stability.
208
How is surveillance different from surveys?
Surveys are time-bound and often a research activity, while surveillance is ongoing and a public health activity.
209
What are the limitations of surveillance?
Under-reporting, poor collation, poor analysis, delayed distribution, and the need to recognize anomalies.
