more tb

Question 1

outline the difference between latent and active TB.

Answer 1

Active TB:
Symptomatic, contagious, bacteria multiplying; symptoms include cough (blood), fever, night sweats, weight loss. Requires treatment (6–9 months).

Latent TB:
Asymptomatic, non-contagious, bacteria dormant; risk of activation if immunity weakens. Diagnosed via TST/IGRA; preventive treatment advised.

Question 2

outline which individuals are at risk of tb (risk factors).

Answer 2

• immunocomprimised individuals
• close contact of active TB patients
• people in crowded or high risk areas such as hospitals
• individuals with pre-existing conditions
• smokers
• infants, children and enderly - weakened immune system
• residents or travelers o TB-endemic regions
• those subject to poor living conditions and lack of access to healthcare

Question 3

how does latent and active TB present clinically, including the tests used to diagnose and the results.

Answer 3

latent:
- no symtpoms
- normal physical examination
- no evidence of active disease on chest x-ray
detection:
- tuberculin skin test

active:
- persistant cough
- fever and chills
- night sweats
- unintentional weight loss
- fatigue and wekness
- chest pain and difficulty breathing
- abnormal chest x-ray
- extrapulmonary TB (spread) may cause extra symptoms

Question 4

when does active tb happen in relation to when latent tb happens?

Answer 4

latent TB occurs in most immuneohealthy people, containing the bacterium.
when the immune system fails to contain the bacteria, the bacteria infects the surrounding tissues

Question 5

explain how M. tuberculosis causes damage and disease.

Answer 5

• triggers inflammatory response by macrophages - tissue damage
• caseous necrosis in lung granulomas
• if spreads can cause necrosis of other organs and tissues

Question 6

outline the geographical and demographic drivers of TB incidence in the UK and globally.

Answer 6

• low and middle income countries
• sub-saharan africa
• southeast asia
• eastern europe
• high rates of HIV co-infection
• areas of limited healthcare access
• overcrowding
• immigration patterns
• malnutrition

Question 7

with treatment of active TB come challenges of adherance, adverse effects and drug resistance, explain these.

Answer 7

adherence:
long treatment duration - non-complience risk leading to treatment or relapse

adverse effects:
- hepatotoxicity
- peripheral neuropathy
- GI upset
- hypersensitivity reactions

drug resistance:
- inadequate adherence to treatment promotes resistance
- MDR-TB XDR-TB

Question 8

with treatment of active TB come challenges of adherance, adverse effects and drug resistance, explain these.

Answer 8

adherance:
due to no symtpoms - less likely to adhere

adverse effects:
- hepatotoxicity
- GI upset

drug resistance:
complex in populations of MDR-TB