MIDTERMS: POTT’S DISEASE

Question 1

What is the most common site of bone and joint tuberculosis (TB)?

Answer 1

The spine, with the lower thoracic region having the greatest incidence.

Question 2

Which bacterium is responsible for Pott’s Disease?

Answer 2

Mycobacterium tuberculosis.

Question 2

: What is the main characteristic deformity in Pott’s Disease?

Answer 2

A painful deformity of the spine accompanied by paraplegia, often resulting in kyphosis.

Question 2

Describe the typical pathologic progression of Pott’s Disease.

Answer 2

The infection begins in the cancellous bone of the vertebral body, spreads to the anterior longitudinal ligament, narrows the intervertebral disc, and affects adjacent vertebrae, leading to collapse and kyphosis.

Question 2

What type of healing occurs in Pott’s Disease?

Answer 2

Healing occurs by gradual fibrosis and new bone formation, which may result in bony ankylosis.

Question 2

On X-ray, how does an abscess caused by Pott’s Disease typically appear?

Answer 2

As a fusiform or flask-shaped shadow encircling the spine.

Question 3

What is a common complication of lumbar vertebra involvement in Pott’s Disease?

Answer 3

Psoas abscess, which may rupture to the skin.

Question 3

What radiographic sign is indicative of a gibbus deformity in Pott’s Disease?

Answer 3

A paravertebral soft-tissue mass and radial extension of the ribs, resembling spokes of a wheel.

Question 3

True or False: The lesions seen in Pott’s Disease are exclusive to tuberculosis and cannot be seen in other conditions.

Answer 3

False. The lesions can also be seen in other granulomatous and pyogenic conditions.

Question 3

What are the primary causes of paraplegia in Pott’s Disease?

Answer 3

Compression due to abscess, edge of bone or disc secondary to kyphosis, edema of the spinal cord, and thrombosis of local blood vessels.

Question 3

What is the initial presentation of paraplegia in Pott’s Disease?

Answer 3

Gait disturbance.

Question 3

What are some other signs and symptoms of paraplegia?

Answer 3

Mild weakness, paralysis, spastic paraplegia with hyperactive reflexes, sensory changes, and sphincter problems

Question 3

What is the conservative management approach for Pott’s Disease?

Answer 3

Indicated in cases of minimal vertebral destruction and includes bed rest, bracing, and a combination of antitubercular therapy for 18 months to 2 years.

Question 3

What is Isoniazid (INH) used for in the treatment of TB?

Answer 3

It is the first-line drug of choice for controlling tuberculosis, inhibiting the formation of mycolic acid in the cell wall of M. tuberculosis.

Question 3

What is the role of Rifampicin in tuberculosis treatment?

Answer 3

It is used in conjunction with isoniazid for active TB and inhibits the initiation of RNA synthesis by binding to DNA-dependent RNA polymerase.

Question 3

How does Pyrazinamide work against tuberculosis?

Answer 3

It disrupts membrane energetics and inhibits membrane transport functions in Mycobacterium tuberculosis.

Question 3

What is the mechanism of action of Ethambutol (EMB)?

Answer 3

It specifically inhibits the synthesis of arabinan in the cell walls of Mycobacterium tuberculosis.

Question 3

Why is Streptomycin not commonly used for tuberculosis today?

Answer 3

Although it was the first antibiotic for TB, it is now less favored due to its mechanism, which damages cell membranes and inhibits protein synthesis.

Question 3

What are the goals of surgical management in Pott’s Disease?

Answer 3

To evacuate pus, provide stability, prevent deformity, and promote healing.

Question 3

What surgical procedure is commonly used in managing Pott’s Disease?

Answer 3

Anterior Decompression with Spinal Fusion (ADSF).