Other TB infections Flashcards
Describe the form of miliary TB
Severe
Describe the spread that causes miliary TB
Hematogenous
Describe the dose of bacteria which is spread in miliary TB
Large
Describe the immunity of the patient which has miliary TB
Very low
Describe the occurrence of the foci when cut section and outer surfaces of all organs is done
Multiple
Describe their shape
Rounded
Describe their size
Equal
Describe their color
Yellowish
What are the small foci related to?
Blood vessels
What are these small foci not surrounded by?
Red zone
What is this red zone of?
Hyperaemia
What is seen under the microscope in miliary TB? (2 points)
Tubercles
Central caseation
Describe this caseation
Central
What are the cells seen under the microscope in miliary TB?
Langhans giant cells
Describe the number of these Langhans giant cells
Few
What is the differential diagnosis of Miliary TB?
Pyaemic abscesses
Describe the prognosis of Miliary TB
Fatal
What occurs in the primary skin TB?
Primary skin complex
What is the secondary skin TB a part of?
Miliary TB
Which miliary TB is the secondary skin TB a part of?
Generalized
What occurs in the secondary skin TB?
Lupus vulgaris
Describe Lupus vulgaris
Infection
Describe this infection
Hematogenous
Where does this hematogenous infection mainly occur in?
Face
Describe the shape of the TB ulcer
Irregular
Describe the edge of the TB ulcer
Undermined
What occurs in the edge of the TB ulcer?
Destruction
Which layer is this destruction more in?
Deeper
Describe the margin of the TB ulcer
Cyanotic
Describe the shape of this margin
Irregular
What occurs in the floor of the TB ulcer?
Caseation
What occurs in the base of the TB ulcer?
Fibrosis
Describe this base
Indurated
What does the TB ulcer show under the microscope? (2 points)
Tubercle
Caseation
What are the 2 differential diagnosis of the TB ulcer?
Syphilitic
Malignant ulcers
How does the bacteria enter the intestine in TB enteritis?
Swallowed
How many organs are rarely affected by the swallowing of bacteria?
3
What are the 3 organs that are rarely affected by the swallowing of the bacteria?
Mouth
Pharynx
Oesophagus
What makes these 3 organs rarely affected by the swallowing of the bacteria?
Stratified squamous epithelium
What is another organ that isn’t affected by the swallowing of the bacteria?
Stomach
What feature of the stomach doesn’t make it affected by the swallowing of the bacteria?
Acidity
Describe the dose needed as a result
Large
What is this large dose needed to reach?
Intestine
What are the 2 types of intestinal TB?
Primary
Secondary
What is the type of the primary intestinal TB?
Childhood
What causes the primary intestinal TB?
Ingestion
What is ingested, causing primary intestinal TB?
TB bacteria
What is this TB bacteria of?
Bovine
Where is this bovine TB bacteria found in?
Milk
What is formed in the primary intestinal TB?
Primary intestinal complex
What is this primary intestinal complex formed of? (3 points)
Intestinal parenchymatous lesion
TB Lymphangitis
TB Lymphadenitis
What occurs in this intestinal parenchymatous lesion?
Engulfment
What is engulfed?
TB bacteria
What is this TB bacteria engulfed by?
Macrophage
What are these macrophages of?
Peyer’s patches
What is this engulfment followed by?
Tubercle formation
What does this tubercle formation undergo?
Ulceration
What occurs in the TB Lymphadenitis?
Tabes mesenterica
What is affected in Tabes mesenterica?
Mesenteric LNs
How are the Mesenteric LNs affected in Tabes mesenterica?
Enlarged
What then happens to the Mesenteric LNs?
Fuse together
Describe the fusion of the Mesenteric LNs
Matted
What causes these Mesenteric LNs fuse together?
Peri-lymphadenitis
What is the good fate of the primary intestinal TB?
Healing
What is the bad fate of the primary intestinal TB?
Spread
How many types in which the primary intestinal TB spread by?
3
What are the 3 types in which the primary intestinal TB spread by?
Local
Lymphatic
Blood
How many local sites does the primary intestinal TB spread to?
2
What are the 2 local sites in which the primary intestinal TB spread to?
Peritoneum
Fallopian tube
What is the lymphatic site in which the primary intestinal TB spread to?
Other LNs
What is an example of the blood spread of the primary intestinal TB spread to?
Miliary TB
What are another sites in which the primary intestinal TB spread to?
Natural passages
What causes secondary intestinal TB?
Swallowing of sputum
Which patients get secondary intestinal TB due to swallowing of sputum?
Those with pulmonary TB
Where does the secondary intestinal TB start in?
Peyer’s patches
What does the secondary intestinal TB start in the Peyer’s patches as?
TB reaction
What occurs in this TB reaction?
Destruction
What does this TB reaction destroy? (2 points)
Submucosa
Mucosa
What is formed as a result of this destruction?
Ulcer
Where is this ulcer?
Parallel to the long axis of the intestine
What does this ulcer later take the shape of?
Peyer’s patches
What does this ulcer do so that it takes the shape of the Peyer’s patches later?
Extension
Where does this ulcer extend in?
Lymphatic vessels
What shape does this ulcer take when it extends in the lymphatic vessels?
Girdle
What does this ulcer do so that it takes the shape of the girdle?
Encircles the bowl
Describe the axis of this ulcer that encircles the bowl
Perpendicular
What is the axis of this ulcer perpendicular to?
The axis of the intestine
Describe the ulcer which its axis perpendicular to the axis of the intestine
Transverse
Describe the margin of this ulcer
Cyanotic
Describe the shape of the margin of this ulcer
Irregular
Describe the edge of this ulcer
Undermined
Describe the floor of this ulcer
Caseous
Describe the color of the floor of this ulcer
Yellow
Describe the base of this ulcer
Indurated
What does the peritoneal covering of this ulcer show?
Multiple tubercles
What is not affected in this ulcer?
LN
What is seen in this ulcer under the microscope?
Tubercles
What are the 6 complications of the intestinal TB?
Hemorrhage Intestinal obstruction Fecal fistula Perforation Spread Amyloidosis
What are the 2 sites in which the intestinal TB can spread to?
Peritoneum
Fallopian tubes
What is the TB Lymphadenitis a common cause of?
Lymphadenopathy
Where does the Lymphadenopathy occur in?
Children
What is the TB Lymphadenitis a part of, which is considered as a mode of infection?
Primary complex
What is a type of spread which is considered as a mode of infection?
Lymphatic
Describe another spread which is considered as a mode of infection
Hematogenous
Describe the prevalence of this hematogenous spread
Rare
Describe the LN in TB Lymphadenitis
Enlarged
Describe the LN when touched in TB Lymphadenitis
Soft
What is shown in the LN in the cut section?
Caseous material
What could happen to this caseation?
Liquefaction
What is liquefaction done by?
Enzymes
What are these enzymes of?
Polymorphs
What may this caseation open on?
Skin
What could this caseation open on the skin by?
Sinus
What would then happen to the caseous material?
Discharged
What is this caseation ,which is liquefied by the enzymes of polymorphs and may open on the skin by a sinus, known as?
Cold abscess
Describe the color of this caseous material
Creamy
What feature of the LN is affected in TB Lymphadenitis?
Capsule
What happens to the LNs due to its affected capsule?
Fusion
Describe this fusion
Matting
Describe the 2 forms of TB Lymphadenitis seen under the microscope
Non caseating
Caseating
What are non caseating in TB Lymphadenitis?
Multiple tubercles
Where are these multiple non caseating tubercles positioned at?
Periphery
Where do these multiple non caseating tubercles go then?
Centrally
What are these multiple non caseating tubercles separated by?
Rim
Describe this rim
Thin
What is this thin rim of?
Nodal tissue
Where does the caseating start in caseating TB Lymphadenitis?
Tubercles
What happens to the tubercles in caseating TB Lymphadenitis?
Fuse together
What happens when these tubercles fuse together?
Replace the whole LN
What are the 4 complications of TB Lymphadenitis?
Spread
Rapture
Sinus formation
Secondary amyloidosis
What is the TB of bone known as?
TB osteomyelitis
Describe the disease of TB osteomyelitis
Destructive
What is difficult to do with TB osteomyelitis?
Control
What are the 2 sites affected by TB osteomyelitis?
Spine
2 Joints
Which 2 vertebrae are especially affected by TB osteomyelitis?
Thoracic
Lumber
Which 2 joints are affected by TB osteomyelitis?
Knee
Hip
What is the most common site of TB of bone?
TB of vertebrae
What is the TB of vertebrae known as?
Pott’s disease
What does the TB of vertebrae produce?
Destruction
What are destructed in the TB of vertebrae?
2 points
Vertebral bodies
Intervertebral discs
What are the 4 complications of TB of vertebrae?
Deformity
Cold abscess
Secondary amyloidosis
Paraplegia
What are these 2 deformities?
Kyphosis
Scoliosis
What happens to the bone in the cold abscess?
Destruction
Describe this destruction (2 points)
Extensive
Caseous
What is formed as a result of this destruction?
Tuberculous pus
Where could this tuberculous pus track to?
Surface
What are the 2 sites of cold abscess?
Posterior mediastinal
Inguinal region
What the abscess in the inguinal region known as?
Psoas
What causes secondary amyloidosis?
Chronic tissue destruction
What is the percentage range of cases which have paraplegia due to TB of vertebrae?
10-25%
What causes this paraplegia? (2 points)
Compression
Cold abscess
What causes this compression?
Collapsed vertebrae
Which site of cold abscess causes paraplegia?
Extra dural
What does the TB of male genital tract mostly come from?
Spread
Describe the spread that the TB of male genital tract mostly come from
Hematogenous
Where is this hematogenous spread from?
Pulmonary lesion
What is mainly affected in the TB of male genital tract?
Globus minor
What is this globus minor of?
Epididymis
What could happen to the globus minor of the epidydymis?
Ulceration
What could the globus minor of the epididymis open as if it ulcerates?
Posterior sinus
What may then be affected?
Testis
Which 2 tuberculosis are a less common cause of TB of male genital tract when spread?
Renal
Urinary tract
What are affected in the TB of male genital tract in this case?
(2 points)
Prostate
Seminal vesicles
Which tuberculosis is the most affected in the TB of the female genital tract?
Salpingitis
What does the infection of TB salpingitis in the female genital tract mostly come from?
Spread
Describe the spread that the infection of the TB salpingitis in the female genital tract mostly come from
Hematogenous
Where is this hematogenous spread from?
Pulmonary lesion
What does the TB salpingitis in the female genital tract cause?
Infertility
Describe the TB in the area, which causes this infertility
Prevalent
What does the Renal TB come from?
Spread
Describe the spread that the renal TB come from
Hematogenous
The renal TB comes from hematogenous spread in which type of TB?
Secondary
What does the renal TB ascends from?
Urinary bladder
What does the renal TB result in? (3 points)
TB pyelonephritis
Miliary TB
Tuberculoma
Describe the kidney in TB pyelonephritis
Surgical
Describe the affection that occurs in TB pyelonephritis (2 points)
Unilateral
Bilateral
Describe the onset of the TB pyelonephritis infection
Renal
What then happens to this infection by time?
2 points
Enlarges
Ruptures
What does this infection rupture into?
Pelvicalyceal system
What does this lead to? (4 points)
TB urethritis
Cystitis
Prostatitis
Epididymo-orchitis
What are scattered in the miliary TB of kidney?
Tuberculous granulomas
Describe the size of these tuberculous granulomas
Small
Describe the number of these small tuberculous granulomas
Very large
Where are these small tuberculous granulomas scattered throughout?
Both kidneys
What does the infection of the CNS TB come from?
Spread
Describe the spread that the infection of the CNS TB come from
Hematogenous
Where is this hematogenous spread from?
Pulmonary lesion
What are the 2 patterns of CNS affection?2
TB meningitis
Tuberculoma
