TB Flashcards
Which mycobacteria (5) cause TB
tuberculosis
bovis
africanum
microti
canetti
what does tuberculosis mean
infection by certain mycobacs which cause tubercles
can certain mycobacs cause nonTB infectionq
yes
what are mycobacteria like (2)
rod shaped bacilli
gram positive
how is TB spread
airborne particles
where do inhaled TB commonly settle
sub pleural area mid and lower lungs
what do macrophages engulfing TB form
Ghon Focus
where does Ghon focus go and what does it form
to hilar lymph nodes Ghon complex
(Ghon focus + lymph nodes)
of 100 ppl infected with TB, what happens
TB risk factors
where can you get TB
everywhere even bones
what is miliary TB
TB spread everywhere
difference between sarcoid and TB granulomas
TB caseous gross so gross
B or T cells in TB
T
highest risk group for post-primary (reactivated) TB
HIV pts
why is post-primary TB worse
kind of like autoimmune disease. Much more damage
TB signs
pyrexia
possible chest crackles
CXR abnormality
if large cavitations, hyperresonance
TB symptoms
chronic cough
Haemoptysis
anorexia
night sweats
fever
weight loss
tiredness malaise
how do confirm diagnosis of TB
somthing then something else
3 x early morning sputum
if pt can’t cough, broncho-alveolar lavage
then 2 x culture - solid and liquid
what is TB in the neck called
lymphadenitis (used to be scrofula)
why would TB cause ascites
peritoneal involvement
microscope difference between CSF findings in meningitis and TB meningitis
normally neutrophils but in TB lots of lymphocytes (T cells)
CSF in TB meningitis
very raised proteins, lymphocytosis
TB in spine is called
Pott’s disease
which lymph nodes most common for extra-pulmonary TB
cervical
how can you tell positive PPD test?
measure the induration, not the erythema
which test for TB in the UK
interferon gamma release assay
firrst line tx latent TB
Isoniazid (plus pyridoxine/vitamin B6)
OR
Isoniazid (plus pyridoxine) and rifampicin
firrst line tx active TB
4 drugs
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol
side effectsRifampicin
Isoniazid
Pyrazinamide
Ethambutol
Rifampicin:
Raised transaminases (liver enzymes)
Induces cytochrome P450 –affect other drugs metabolism
Orange secretions – urine, tears
Isoniazid
Peripheral neuropathy (prevent with pyridoxine10mg/d)
Hepatotoxicity
Pyrazinamide
Hepatotoxicity
Ethambutol
Visual disturbance
TB disease adherence
must be closely monitoresd
