Session 7 Flashcards
Define latency
Bacteria is in a dormant form for many years as the immune system cannot kill it, but can control it
What are the outcomes of a Primary infection?
Goes to a Primary complex which can either;
End in resolution
Undergo local progression/distant disease
Undergo tuberculin conversion
Define Tuberculin conversion
Patient who has previously had a negative tuberculin skin test develops a positive tuberculin skin test at a later date
How can post Primary tuberculosis occur?
Exogenous reinfection
Endogenous reactivation of a latent infection thought to be resolved (Reactivation TB)
What are some of the symptoms of respiratory TB?
Malaise & fatigue Weight loss Fever - Low grade or hectic Breathlessness due to pleural effusion Haemoptysis
What are some of the signs of respiratory TB?
Pallor Fever Clubbing (In long standing disease only) Localised wheezing (If bronchioles narrowed) Cervical nodes palpable
What is Nodosum?
A non respiratory sign of TB.
Lumps on the anterior of the leg that are red/blue, elevated and tender
What is the stronger risk factor for TB?
Anti TNF alpha treatment (Switches off immune system)
What are some of the types of TB?
Pulmonary TB (Classic TB, Abscesses) Pleural TB (Cavity can get filled with pus, hypersensitivity) Lymph node TB (In the neck, intrathoracic nodes may collapse into bronchi) Osteoarticular TB TB Spondylitis (Starts in sub chondral bone and spreads to vertebral bodies and joint space then spreads to spine) Miliary TB (Bacilli spread through blood stream)
What are the main investigations for TB?
Chest x-ray
Sputum sample
What findings can be on a TB chest x ray?
Miliary shadowing Large effusions Cardiac enlargement Cavities Calcifications
How can you treat TB?
Rifampicin
Multi drug treatment to try and reduce resistance and prevent it from developing further
What is Heaf testing?
A way of testing for latency of TB
Response is graded I - IV and indicate post or present infection
What is DOT?
Directly observed therapy
Recommended for patients who are unlikely to comply eg homeless
What are some of the risk factors for lung cancer?
COPD Asbestos Radon Occupational carcinogens Diet (Deficiency in some vitamins) Genetic factors