TB Flashcards

1
Q

Which mycobacteria (5) cause TB

A

tuberculosis
bovis
africanum
microti
canetti

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2
Q

what does tuberculosis mean

A

infection by certain mycobacs which cause tubercles

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3
Q

can certain mycobacs cause nonTB infectionq

A

yes

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4
Q

what are mycobacteria like (2)

A

rod shaped bacilli
gram positive

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5
Q

how is TB spread

A

airborne particles

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6
Q

where do inhaled TB commonly settle

A

sub pleural area mid and lower lungs

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7
Q

what do macrophages engulfing TB form

A

Ghon Focus

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8
Q

where does Ghon focus go and what does it form

A

to hilar lymph nodes Ghon complex

(Ghon focus + lymph nodes)

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9
Q

of 100 ppl infected with TB, what happens

A
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10
Q

TB risk factors

A
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11
Q

where can you get TB

A

everywhere even bones

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12
Q

what is miliary TB

A

TB spread everywhere

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13
Q

difference between sarcoid and TB granulomas

A

TB caseous gross so gross

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14
Q

B or T cells in TB

A

T

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15
Q

highest risk group for post-primary (reactivated) TB

A

HIV pts

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16
Q

why is post-primary TB worse

A

kind of like autoimmune disease. Much more damage

17
Q

TB signs

A

pyrexia
possible chest crackles
CXR abnormality
if large cavitations, hyperresonance

18
Q

TB symptoms

A

chronic cough
Haemoptysis
anorexia
night sweats
fever
weight loss
tiredness malaise

19
Q

how do confirm diagnosis of TB

somthing then something else

A

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

then 2 x culture - solid and liquid

20
Q

what is TB in the neck called

A

lymphadenitis (used to be scrofula)

21
Q

why would TB cause ascites

A

peritoneal involvement

22
Q

microscope difference between CSF findings in meningitis and TB meningitis

A

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

23
Q

CSF in TB meningitis

A

very raised proteins, lymphocytosis

24
Q

TB in spine is called

A

Pott’s disease

25
which lymph nodes most common for extra-pulmonary TB
cervical
26
how can you tell positive PPD test?
measure the induration, not the erythema
27
which test for TB in the UK
interferon gamma release assay
28
firrst line tx latent TB
Isoniazid (plus pyridoxine/vitamin B6) OR Isoniazid (plus pyridoxine) and rifampicin
29
firrst line tx active TB
4 drugs Rifampicin Isoniazid Pyrazinamide Ethambutol
30
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
31
TB disease adherence
must be closely monitoresd
32