TB

Question 1

Which mycobacteria (5) cause TB

Answer 1

tuberculosis
bovis
africanum
microti
canetti

Question 2

what does tuberculosis mean

Answer 2

infection by certain mycobacs which cause tubercles

Question 3

can certain mycobacs cause nonTB infectionq

Answer 3

yes

Question 4

what are mycobacteria like (2)

Answer 4

rod shaped bacilli
gram positive

Question 5

how is TB spread

Answer 5

airborne particles

Question 6

where do inhaled TB commonly settle

Answer 6

sub pleural area mid and lower lungs

Question 7

what do macrophages engulfing TB form

Answer 7

Ghon Focus

Question 8

where does Ghon focus go and what does it form

Answer 8

to hilar lymph nodes Ghon complex

(Ghon focus + lymph nodes)

Question 9

of 100 ppl infected with TB, what happens

Answer 9

Question 10

TB risk factors

Answer 10

Question 11

where can you get TB

Answer 11

everywhere even bones

Question 12

what is miliary TB

Answer 12

TB spread everywhere

Question 13

difference between sarcoid and TB granulomas

Answer 13

TB caseous gross so gross

Question 14

B or T cells in TB

Answer 14

T

Question 15

highest risk group for post-primary (reactivated) TB

Answer 15

HIV pts

Question 16

why is post-primary TB worse

Answer 16

kind of like autoimmune disease. Much more damage

Question 17

TB signs

Answer 17

pyrexia
possible chest crackles
CXR abnormality
if large cavitations, hyperresonance

Question 18

TB symptoms

Answer 18

chronic cough
Haemoptysis
anorexia
night sweats
fever
weight loss
tiredness malaise

Question 19

how do confirm diagnosis of TB

somthing then something else

Answer 19

3 x early morning sputum
if pt can’t cough, broncho-alveolar lavage

then 2 x culture - solid and liquid

Question 20

what is TB in the neck called

Answer 20

lymphadenitis (used to be scrofula)

Question 21

why would TB cause ascites

Answer 21

peritoneal involvement

Question 22

microscope difference between CSF findings in meningitis and TB meningitis

Answer 22

normally neutrophils but in TB lots of lymphocytes (T cells)

Question 23

CSF in TB meningitis

Answer 23

very raised proteins, lymphocytosis

Question 24

TB in spine is called

Answer 24

Pott’s disease

Question 25

which lymph nodes most common for extra-pulmonary TB

Answer 25

cervical

Question 26

how can you tell positive PPD test?

Answer 26

measure the induration, not the erythema

Question 27

which test for TB in the UK

Answer 27

interferon gamma release assay

Question 28

firrst line tx latent TB

Answer 28

Isoniazid (plus pyridoxine/vitamin B6)
OR
Isoniazid (plus pyridoxine) and rifampicin

Question 29

firrst line tx active TB

Answer 29

4 drugs
Rifampicin

Isoniazid

Pyrazinamide

Ethambutol

Question 30

side effectsRifampicin

Isoniazid

Pyrazinamide

Ethambutol

Answer 30

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

Question 31

TB disease adherence

Answer 31

must be closely monitoresd