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ICC1 > extra-pulmonary TB > Flashcards

extra-pulmonary TB Flashcards

1
Q

how ddoes extra-pulmonary Tb happen ?

A

through hematogenous dissemination
infection extending directly from nearby organ

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2
Q

when does miliary TB happen ?

A

after primary infection nor
after reactivation of a latent focus

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3
Q

which organs are more commonly affected when it comes to miliary TB ?

A

lungs and bone marrow

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4
Q

miliary tb is common in what age group and what type of patients ?

A

immunocompromised
children
elderly

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5
Q

what may intermittent dissemination of tubercle bacilli lead to ?

A

fever of unknown origin

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6
Q

what are the results of the involvement off the bone marrow in miliary TB ?

A

anaemia
thrombocytopenia
leukemoid reaction ( increased WBC )

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7
Q

what can TB meningitis be prevented by ?

A

childhood vaccination with BCG

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8
Q

what specific signs are found to be positive in TB meningitis ?

A

kernig sign
brudzinski sign

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9
Q

what is the progression of conscious level in TB ?

A

conscious with abnormal CSF
drowsiness or stupor with neurologic signs
coma

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10
Q

what does the presence of focal neurological signs in a patient with TB meningitis suggest ?

A

tuberculoma

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11
Q

what is the presentation of genitourinary TB in men ?

A

may manifest as pyelonephritis
enlarged scrotal mass

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12
Q

what is the presentation of genitourinary TB in women ?

A

chronic pelvic pain
anterior thigh abscess
sterility
ectopic pregnancy

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13
Q

what type of patients are more associated with TB peritonitis ?

A

alcoholics with cirrhosis

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14
Q

what are the symptoms of TB pericarditis ?

A

fever
pleuritic and positional chest pain
pericardial friction rub
pericardial tamponade may occur

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15
Q

which lymph nodes are commonly affected when it comes to TB lymphadenitis ?

A

posterior cervical
supraclavicular chains

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16
Q

what is the complication that may occur in TB lymphadenitis ?

A

formation of fistula

17
Q

what are the cutaneous forms of tuberculosis ?

A

1- lupus vulgaris
2- tuberculosis verrucosa cutis - prosector’s ward

18
Q

where is lupus vulgaris seen ?

A

on the face of a sensitized patient

19
Q

what is Tb of the spine ?

A

pott’s disease

20
Q

what is the causative organism in GIT TB ?

A

M bovis

21
Q

what is the presentation of GIT TB ?

A

ulcers of the mouth and the oropharynx may form
pain, diarrhoea, obstruction, and haematochezia.

22
Q

what does GIT TB mimic ?

A

acute appendicitis

23
Q

if there aren’t enough organisms for the culture what test should be used instead ?

A

NAAT PCR

24
Q

what CSF finding is associated with TB ?

A

glucose level less than 50%
elevated protein levels
ADA cut off level of 8 differentiates TB meningitis from other causes of lymphocytic meningitis

25
Q

what imaging modality is preferred if spine disease is suspected ?

A

MRI

26
Q

what is the treatment duratioin ?

A

6-9 months
9-12 months in meninges affection

27
Q

why are corticosteroids used ?

A

to prevent fibrosis in serositis, peritonitis etc

28
Q

when does TB of the liver occur and what is the main presentation?

A

advanced pulmonary TB
miliary TB
obstructive jaundice is the main presentation

29
Q

what is the standard regimen for extra pulmonary TB?

A

usually the regimen is 6 to 9 months
Tb meningitis : 9- 12 months
Tb bones or joints : 9 months

30
Q

what replacements should be made in TB meningitis ?

A

ethambutol should be replaced by streptomycin

31
Q

what are the indications for surgery in extra pulmonary TB ?

A

1- drain empyema, cardiac tamponade or CNS abscess
2- close bronchopleural fistulas
3- resect infected bowel
4- potts disease

32
Q

is surgery necessary in TB lymphadenitis ?

A

no unless for diagnostic purposes

ICC1 (50 decks)

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