Pulmonary Tuberculosis Flashcards
Facilitate the survival of M. Tuberculosis with macrophage (Harrison pp 1103)
Lipoarabinomanan
Responsible for the acid fastness of the M. Tuberculosis (Harrison pp 1103)
Mycolic Acid
What country has the highest proportions of MDR disease among NEW TB cases (Harrison pp 1104)
Former Sovient Union
Resistance to 2nd line Anti TB drugs (Harrison pp 1104)
Extended drug resistant TB
2nd line Anti-TB drugs (Harrison pp 1105)
Fluoroquinolones
Amikacin
Kanamycin
Capreomycin
Countries that are resistance to ALL Anti-TB drugs (Harrison pp 1105)
I^3
I ndia
I taly
I ran
Tuberculosis is most commonly transmitted through _____ (Harrison pp 1105)
Droplet nuclei
What are the important determinants of the likelihood of transmission? (Harrison pp 1105)
IDS Intimacy Duration of exposure Degree of infectiousness Shared environment
Most infectious patients with M. Tuberculosis are the following: (Harrison pp 1105)
Cavitary TB
Laryngeal TB
10^5 - 10^7 AFB/ml sputum containing
One of the most important factors in the transmission of tubercle bacilli (pp 1105)
Crowding in poorly ventilated rooms
Important determinant of risk of disease AFTER infections (Harrison pp 1105)
AGE
Risk factors for ACUTE tuberculosis in patient who have been infected with tubercle bacilli (Harrison pp 1005)
Post transplantation
HIV infection
Jejunoileal bypass
Most potent risk factor for TB among infected individuals (Harrison pp 1105)
HIV co-infection
This is the key in attenuating mutation and also seen absence in BCG vaccine (Harrison pp 1106)
Region of difference 1 (RD1)
It is ______ critical at the early stage of macrophage activating response (Harrison pp 1107)
Cell Mediated Immunity (CMI)
Tissue damaging response (Harrison pp 1106)
Delayed-Type hypersensitivity (DTH)
TH1 cells produces _____ (Harrison pp 1107)
Macrophage
Monocytes
TH2 cells produces ______ (Harrison pp 1107)
IL-4, IL-5, IL-10, IL-13
Uses primarily for the detection of M. Tuberculosis infection in person without symptoms (Harrison pp 1107)
Tuberculin Skin Test (TST)
Primary pulmonary TB affects what lobes? (Harrison pp 1108)
Middle and lower lung zones
Lesion after initial infection that usually peripheral and accompanied by transient hilar or paratrachael lymphadenopathy (Harrison pp 1108)
Ghon Focus
Ghon focus is associated with the following disease (Harrison pp 1108)
Erythema nodosum
Phlyctenular conjunctivitis
Ghon focus w/ or w/o overlying pleural reaction thickening and regional lymphadenopathy (Harrison 1108)
Ghon complex
What is usually affected segments with post primary (adult type) disease? (Harrison pp 1108)
Apical and posterior upper lobe
Superior segments of lower lobe
If left untreated, 1/3 succumb to severe pulmonary TB w/in a few months after onset (Harrison pp 1108)
Classic galloping consumption
Rupture of dilated vessel in a cavity (Harrison pp 1108)
Rasmussen’s aneursym
What is the common hematologic findings in post primary (Adult) disease? (Harrison pp 1109)
Mild anemia Leukocytosis Thrombocytopenia Î ESR Î CRP
Extrapulmonary sites most commonly involved in TB (Harrison pp 1109)
- Lymph nodes
- Pleura
- Genitourinary tract
- Bones/joints
- Peritoneum
- Pericardium
Painless swelling of the lymph nodes most commonly at _____ and ________. (Harrison pp 1109)
Posterior cervical
Supraclavicular sites
Necrotizing histocytic lymphadenitis (Harrison pp 1109)
Kikuchi’s disease
Nearly always complication of advanced cavitary pulmonary TB (Harrison pp 1110)
TB of the upper airways
TB of the upper airway involved the following (Harrison pp 1110)
Larynx
Pharynx
Epiglottis
In female genitourinary TB, it is usually involved which sites (Harrison pp 1110)
FEmale
F allopian Tubes
E ndometrium
In male genitourinary TB, it is usually affects which site? (Harrison pp 1110)
Epididymis
Most commonly involved in skeletal TB (Harrison pp 1110)
Spine 40% (Potts Disease)
Hips 13%
Knees 10%
In children, the commonly involved spine would be _______. (Harrison pp 1110)
Uppper thoracic spine
In adults, the commonly involved spine would be _____ (Harrison pp 1110)
Lower thoracic
Upper lumbar vertebrae
The most catastrophic complication of Pott’s disease (Harrison pp 1110)
Paraplegia
Tuberculosis meningitis is spread via (Harrison pp 1110)
Hematogenous spread
Rupture of a subependymal tubercle
What nerve is frequent findings of tuberculosis meningitis? (Harrison pp 1111)
Ocular Nerve
What is the cornerstone of diagnosis for TB meningitis? (Harrison pp 1111)
Lumbar puncture
In TB of the gastrointestinal which is usually involved? (Harrison pp 1111)
Terminal ileum
Cecum
In pericardial TB, it is usually affected or seen in patients ______ and _______. (Harrison pp 1111)
Elderly
HIV infected
What is the definitive diagnosis of pericardial tuberculosis? (Harrison pp 1111)
Pericardiocentesis
What is the pathogonomic of miliary TB? (Harrison pp 1112)
Choroidal tubercles
Rare presentation seen in elderly that is characterized by mild intermittent fever anemia and meningeal involvement. (Harrison pp 1112)
Cryptic miliary TB
It is more common among patient w/ advanced immunosuppression and extrapulmonary TB after taking adminstration of ART. (Harrison pp 1112)
Immune reconstitution inflammatory syndrome
TB immune reconstitution disease
False negative reaction in PPD (Harrsion pp 1112)
Immunosuppression patient
Overwhelming TB
False positive reaction in PPD (Harrison pp 1112)
Nontuberculous mycobacteria
BCG vaccination
Spurious TST conversion resulting from boosting of reactivity on subsequent TST 1-5 weeks after initial test (Harrison pp 1112)
Boosting phenomenom
What are the 3rd line agents for TB? (Harrison pp1115)
Clofazimine Linezolid Amoxicillin/Clavulanic Clarithromycin Carbapenem Imipenem Meropenem
