Resp 8 - Tuberculosis Flashcards

1
Q

Describe Mycobacterium tuberculosis:

A
  • Obligate aerobe
  • Non-motile
  • Rod-shaped
  • Slow growing
  • Acid+Alcohol fast
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2
Q

What stain would you use to test for Mycobacterium tuberculosis?

A
  • Ziehl-Nielson stain

- Auramine stain

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3
Q

How is TB transmitted?

A

Aerosol droplets = sneezing/coughing/talking

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4
Q

Describe the granuloma formed in Tuberculosis:

A

Infected macrophages + Langhans giant cells surrounded by foamy macrophages, surrounded by T lymphocytes in a fibrous cuff, with central caseation.

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5
Q

In what percentage of people with latent TB, does the infection go on to cause post-primary TB?

A

5%

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6
Q

What are the risk factors for post-primary TB?

A

Immunocompromised:

  • HIV+
  • IVDU
  • Organ transplant
  • Low body weight
  • Haematological malignancy
  • Severe kidney disease
  • Diabetes mellitus
  • Prolonged corticosteroid use
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7
Q

Give the symptoms of TB:

A
  • Fever
  • Night sweats
  • Severe cough
  • Weight loss/anorexia
  • Tiredness
  • Haemoptysis
  • Breathlessness (if pleural effusion)
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8
Q

Describe the CXR findings of a patient with TB:

A
  • Ill-defined patchy consolidation +/- central cavity formation (appears darker)
  • Usually in apex of lung
  • May see fibrosis (forms during healing)
  • Pleural effusion may be present
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9
Q

What is Scrofula?

A

Cervical lymph node TB infection

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10
Q

What is Pott’s disease?

A

Spinal TB, usually thoracolumbar

= progressive bone destruction

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11
Q

How can you induce sputum production?

A

Give patient nebulised hypertonic saline solution, which liquefies secretions and promotes coughing

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12
Q

What could cause a false positive Mantoux test?

A

BCG vaccination

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13
Q

What could cause a false negative Mantoux test?

A

Immunocompromisation

ie HIV+, IVDU etc

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14
Q

What are the main, 1st line drugs used to treat TB?

A

1) Rifampicin
2) Isoniazid
3) Pyrazinamide
4) Ethambutol

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15
Q

Which anti-TB drug causes orange secretions?

A

Rifampicin

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16
Q

Which anti-TB drug’s are toxic to hepatocytes?

A
  • Isoniazid

- Pyrazinamide

17
Q

Which anti-TB drug causes visual disturbances?

A

Ethambutol

18
Q

Which vitamin is given as a supplement during an antibiotic course for TB?

A

Vitamin D = accelerates recovery

19
Q

What are the risk factors for MDR TB?

A
  • Previous TB prescription
  • HIV+
  • Known contact with MDR TB
20
Q

What type of TB does the BCG mainly vaccinate against?

A
  • TB meningitis

- Miliary TB

21
Q

Who is at particular risk of developing TB in the UK?

A
  • HIV+
  • IVDU’s
  • Overcrowded areas: Prisons/homeless shelters/nursing homes
  • People exposed to high-risk people: healthcare workers, family