Infectious Diseases 12 - TB

Question 1

extrapulmonary TB manifestations

Answer 1

cold abscess - LN in neck
cutaeneous TB
TB meningitis

any system can be infected

Question 2

TB

Answer 2

acid fast bacillus

Zeihl Neelsen stain bright red against blue background

Question 3

risk factors TB

Answer 3

contacts
country high level
homeless
HIV

Question 4

summarise BCG and Mantoux

Answer 4

BCG for those at higher risk
live attenuated
prevents most severe TB but not pulmonary

Mantoux raised if latent, active or vax

Question 5

presenting features of TB

Answer 5

FLAWS
cough
raised LNs
e nodosum 
spinal pain if Pott's

Question 6

investigating TB

Answer 6

Mantoux
(IGRA)
CXR
cultures
NAAT

Question 7

CXR findings with TB

Answer 7

primary - consolidation, pleural effusion, hilar LNs

latent - cavitation upper zones

disseminated miliary characteristic finding - look at image

Question 8

summarise TB treatment

Answer 8

MDT
RI 6 months
PE 2 months

Question 9

managing TB patient in hospital

Answer 9

test for HIV, hep B, C
test contacts
negative pressure
notify PHE
MDT 
steroids if extrapulmon

Question 10

rifampicin side effects

Answer 10

orange secretions, CYP450 inducer potently

Question 11

isoniazid side effects, how stopped

Answer 11

peripheral neuropathy

give pyridoxine vit B6

Question 12

pyrazinamide side effects

Answer 12

high uric acid, gout

Question 13

ehtambutol side effects

Answer 13

colour blindness

reduced acuity

Question 14

side effect of all RIPE drugs

Answer 14

hepatotoxic