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BSMS 103 > T4 - TB > Flashcards

T4 - TB Flashcards

1
Q

Which geographical areas have the highest prevalence of TB?

A

subsaharan africa and indian subcontinent

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2
Q

which geographical areas have the highest prevalence of drug resistant TB?

A

russia and eastern europe

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3
Q

what % of people will develop active TB within 5 years of exposure?

A

50%

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4
Q

what are TB droplets deposited after they are inhaled from the air?

A

in the terminal air spaces

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5
Q

what type of organism is TB described as?

A

acid fast bacillus

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6
Q

what are two pathological appearances of TB?

A
  • granulomatous inflammation

- central necrosis with caseation

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7
Q

what cells are found in TB patients due to fusion of central infected macrophages?

A

giant cells

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8
Q

what cytokines are secreted in TB and what do they do?

A

IFN gamma - activate macrophages to kill bacteria

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9
Q

what two stains can be used for mycobacteria TB?

A

Ziehl neelsen stain or aura mine rhodamine stain

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10
Q

how many more times are HIV patients at for developing TB?

A

x10

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11
Q

what does smear positive TB indicate?

A
  • can be seen down the microscope
  • high disease burden
  • high risk of transmission
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12
Q

Is TB found only in the LNs transmissible?

A

no

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13
Q

is TB found in the lungs and larynx transmissible?

A

yes

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14
Q

what type of immune therapy can suppress the immune system that stop reactivation of TB?

A

Anti TNF therapy

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15
Q

what is looked for when diagnosing latent TB?

A

immune response to TB proteins or specific antigens

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16
Q

what two tests can be used to detect TB?

A
  • tuberculin skin test (Mantoux)

- IFN gamma release assays

17
Q

what cells does the Mantoux test require to work?

A

circulating memory T cells

18
Q

what two things could cause a false negative on a Mantoux test?

A

immunosupression or being generally unwell

19
Q

what precedes an IFN release assay?

A

stimulation with TB specific antigens

20
Q

which TB test has a good correlate with TB exposure?.

A

IFN release assay

21
Q

does an IFN release assay differentiate between active and latent TB?

A

no

22
Q

what % of TB is pulmonary?

A

55%

23
Q

what are the main symptoms of pulmonary TB and how is it diagnosed?

A

Symptoms: cough, haemoptysis, chest pain, weight loss, fever, night sweats

Diagnosed: CXR and sputum sample

24
Q

what is seen on CXR in pulmonary TB?

A

upper lobe changes

25
Q

what may be seen on CXR in extra pulmonary TB?

A

hilar lymphadenopathy

26
Q

what are the three main things associated with TB lymphadenitis?

A
  • gets worse on treatment
  • can form sinus tracts with chronic discharge
  • cold abscess formation
27
Q

what diagnostic test can be done for military TB with GI/CNS symptoms?

A

lumbar puncture to look for TB in the CSF

28
Q

what liver symptom is seen in 50% of miliary TB patients?

A

hepatomegaly

29
Q

is miliary TB usually acute or chronic onset?

A

acute

30
Q

what is seen on CXR for a patient with miliary TB?

A

nodular change and dots in lung fields

31
Q

what are the phases and duration of standard TB drug therapy?

A
  • initial phase of quadruple therapy = 2 months

- followed by 4 months of dual therapy

32
Q

what are the phases and duration of CNS involved TB drug therapy?

A
  • initial phase quadruple therapy = 2 months

- followed by 10 months of dual therapy

33
Q

what drugs make up quadruple therapy in TB?

A

isoniazid, rifampicin, pyraxinamide & ethambutol

34
Q

what drugs make up dual therapy in TB?

A

isoniazid and rifampicin

35
Q

what can be used to observe compliance to TB therapy?

A

video observed therapy or hospital admission if necessary

36
Q

what are the main treatment side effects caused by all drugs in quadruple therapy?

A

Nausea and vomiting and skin rashes

37
Q

what TB drug should not be given in ITU and why?

A

ethambutol as it can cause blindness which cannot be monitored if patient is in ITU

BSMS 103 (23 decks)

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