extra-pulmonary TB Flashcards
how ddoes extra-pulmonary Tb happen ?
through hematogenous dissemination
infection extending directly from nearby organ
when does miliary TB happen ?
after primary infection nor
after reactivation of a latent focus
which organs are more commonly affected when it comes to miliary TB ?
lungs and bone marrow
miliary tb is common in what age group and what type of patients ?
immunocompromised
children
elderly
what may intermittent dissemination of tubercle bacilli lead to ?
fever of unknown origin
what are the results of the involvement off the bone marrow in miliary TB ?
anaemia
thrombocytopenia
leukemoid reaction ( increased WBC )
what can TB meningitis be prevented by ?
childhood vaccination with BCG
what specific signs are found to be positive in TB meningitis ?
kernig sign
brudzinski sign
what is the progression of conscious level in TB ?
conscious with abnormal CSF
drowsiness or stupor with neurologic signs
coma
what does the presence of focal neurological signs in a patient with TB meningitis suggest ?
tuberculoma
what is the presentation of genitourinary TB in men ?
may manifest as pyelonephritis
enlarged scrotal mass
what is the presentation of genitourinary TB in women ?
chronic pelvic pain
anterior thigh abscess
sterility
ectopic pregnancy
what type of patients are more associated with TB peritonitis ?
alcoholics with cirrhosis
what are the symptoms of TB pericarditis ?
fever
pleuritic and positional chest pain
pericardial friction rub
pericardial tamponade may occur
which lymph nodes are commonly affected when it comes to TB lymphadenitis ?
posterior cervical
supraclavicular chains
what is the complication that may occur in TB lymphadenitis ?
formation of fistula
what are the cutaneous forms of tuberculosis ?
1- lupus vulgaris
2- tuberculosis verrucosa cutis - prosector’s ward
where is lupus vulgaris seen ?
on the face of a sensitized patient
what is Tb of the spine ?
pott’s disease
what is the causative organism in GIT TB ?
M bovis
what is the presentation of GIT TB ?
ulcers of the mouth and the oropharynx may form
pain, diarrhoea, obstruction, and haematochezia.
what does GIT TB mimic ?
acute appendicitis
if there aren’t enough organisms for the culture what test should be used instead ?
NAAT PCR
what CSF finding is associated with TB ?
glucose level less than 50%
elevated protein levels
ADA cut off level of 8 differentiates TB meningitis from other causes of lymphocytic meningitis
what imaging modality is preferred if spine disease is suspected ?
MRI
what is the treatment duratioin ?
6-9 months
9-12 months in meninges affection
why are corticosteroids used ?
to prevent fibrosis in serositis, peritonitis etc
when does TB of the liver occur and what is the main presentation?
advanced pulmonary TB
miliary TB
obstructive jaundice is the main presentation
what is the standard regimen for extra pulmonary TB?
usually the regimen is 6 to 9 months
Tb meningitis : 9- 12 months
Tb bones or joints : 9 months
what replacements should be made in TB meningitis ?
ethambutol should be replaced by streptomycin
what are the indications for surgery in extra pulmonary TB ?
1- drain empyema, cardiac tamponade or CNS abscess
2- close bronchopleural fistulas
3- resect infected bowel
4- potts disease
is surgery necessary in TB lymphadenitis ?
no unless for diagnostic purposes
