Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pulmonology > TB > Flashcards

TB Flashcards

1
Q

TB MO

A

Mycobacterium tuberculosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Mode of transmission of TB

A

spread by the inhalation of
aerosolised droplet nuclei from other infected patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pathophysio of TB

A

1.inhaled MOs enter the alveoli
2.Recruitment of macrophages and lymphocytes
3.macrophages transform into epitheliod and langerhans cells
4.they accumulate with lymphocytes and from granuloma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Ghon focus

A

Numerous granulomas aggregate to
form a primary lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

color of the ghon focus

A

pale yellow, caseous granuloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

location of the ghon focus

A

characteristically situated in the periphery of the lung

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Ghon focus

A

combination of the primary lesion
and regional lymph nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

why are most ABx ineffective against TB

A

1.intrinsic resistance
2.slow growth and dormancy
3.lipid rich cell wall is impermeable to ABx
4.can survive within macrophages and resist phagocytic killing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

function of catalase in MTB

A

resist oxidative injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

function of lipoarabinomannan

A

induce cytokines and resist oxidative injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Primary pulmonary TB

A

infection in individuals lacking previous sensitization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

location of MTB deposition in lungs

A

inhaled bacilli implant in the distal air spaces .lower part of upper lobe or upper part of lower lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Reparative processes of the body against MTB

A

encase the primary complex in a fibrous capsule, limiting the spread of bacilli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

manifestations of primary TB infection

A

Usually asymptomatic , but small transient pleural effusion or erythema nodosum – both are
representative of hypersensitivity manifestations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

main complication of primary TB

A

can erode into bronchial tree lead to acute
TB bronchopneumonia. And also erode into blood vessels leads to miliary TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Primary TB disease Sx

A
  • Lymphadenopathy: hilar (often
    unilateral), paratracheal or
    mediastinal
  • Collapse (especially right
    middle lobe)
  • Consolidation (especially right
    middle lobe)
  • Obstructive emphysema
  • Cavitation (rare)
  • Pleural effusion
  • Miliary
  • Meningitis
  • Pericarditis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

HSR in Primary TB

A

Erythema nodosum
Dactylitis
Conjunctivitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Risk factors of TB

A

1.Extremes of age
2. 1st Gen immigrants of high- prevalence countries
3.Close contact
4.CXR evidence of self-healed TB
5.Smoking
6.Immunosuppression
7.Malignancy
8.DM
9.CKD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Cryptic TB

A
  • Age over 60 years
  • Intermittent low-grade pyrexia of unknown origin
  • Unexplained weight loss, general debility (hepatosplenomegaly in
    25–50%)
  • Normal chest X-ray
  • Blood dyscrasias; leukaemoid reaction, pancytopenia
  • Negative tuberculin skin test
  • Confirmation by biopsy with granulomas and/or acid-fast bacilli in
    liver or bone marrow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Auscultation findings of miliary TB

A

normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Bone marrow involvement of miliary TB

A

Anemia, leucopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

TB meningitis in miliary TB

A

headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Post- primary TB

A

Due to reactivation of previous asymptomatic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

MC location of post-primary TB

A

Apex of the upper lobe - oxygen tension favors the survival of aerobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

post- primary TB can occur in

A

when defenses are weakened
Old age
Pregnancy
Malnutrition
Steroids,immunosuppressive agents
DM, HIV
Lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

clinical presentation of post- primary TB

A
  • Cough
  • Prolonged fever
  • Haemoptysis
  • Poorly resolving pneumonia
  • Unexplained fever , night sweats
  • Nonspecific symptoms - weight loss, anorexia
  • Pleuritic pain
  • Incidental finding on CXR
  • Others – breathlessness, wheeze
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Physical examination of Post-primary TB

A
  • may be normal
  • RS - pleural effusion, apical cavitation, consolidation
  • General - fever, wasting, pallor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Extrapulmonary TB forms

A

Lymph node TB
TB pleural effusion
TB of upper airways
Skeletal TB- Pott’s disease
GUT TB
GI TB
TB meningitis
Miliary TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Routine tests of TB

A

ESR
CRP
FBC
CXR
AFB
Mantoux
Gene XPert/TB- PCR
Gold- Quantiferon TB gold test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

findings of Post- primary TB Ix

A

high ESR
High CRP
CXR- not confirmatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Why is CXR not confirmatory in TB

A

cannot differentiate from healed and active lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

normal CXR in TB excludes?

A

endobronchial tuberculosis, military
tuberculosis, HIV positive patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

sputum examination for AFB

A

D1- supervised sample, D2 -
patient brings an early morning sample, D3 – supervised second sample when the patient
returns

34
Q

Dx TB

A
  • Bacteriologically confirmed tuberculosis
    o 2 sputum DS positive for AFB
    o 1 sputum DS positive with CXR suggestive of pulmonary TB
    o Culture positive TB
    o WHO recommended Rapid diagnostic test positive- X Pert MTB/RIF+
  • Clinically diagnosed tuberculosis
    o Diagnosis on clinical features/ radiology/histology without bacteriological
    confirmation
34
Q

Mantoux Test

A

0.1ml of PPD solution is injected in the flexor aspect of the forearm, reading taken
after 48-72 hours .induration >10mm will confirm the disease

35
Q

when to suspect TB

A

Suspect in a person who is having a persistent cough for > 3 weeks

36
Q

Treatment category I in TB

A

New sputum positive TB
New smear- negative PTB w extensive pulmonary involvement
New cases of severe extra- pulmonary TB

37
Q

Category I TB Intensive phase

A

2HRZE – Isoniazid(H), Rifampicin(R), Pyrazinamide(Z),
Ethambutol(E)

38
Q

Category I TB continuation phase

A

4HR – Isoniazid(H), rifampicin(R)

39
Q

What is given to reduce the risk of isoniazid induced neuropathy

A

Pyridoxine 10mg daily

40
Q

Category II TB

A

Relapses
Treatment failure
Return after default treatment

41
Q

Category II TB Intensive phase

A

2SHRZE + 1HRZE

42
Q

Category II TB continuation phase

A

5HRE

43
Q

Category III TB

A

Sputum negative pulmonary TB with limited parenchymal involvement
Extra-pulmonary TB

44
Q

Category III Intensive Phase

A

2HRZ

45
Q

Category III Continuation Phase

A

4HR

46
Q

Category IV TB

A

chronic cases

47
Q

Category IV TB intesive phase

A

Treatment w at least 3 new drugs which were not previously used

48
Q

Category IV TB continuation phase

A

Treatment continued for 24 months

49
Q

all patients should be referred to the

A

National TB program of the respiratory disease control program of the MOH for follow-up

50
Q

patients of anti-TB treatment should be isolated for

A

two weeks

51
Q

Patients for two months can be treated in

A

Welisara

52
Q

what should be employed in the community

A

DOTS - direct observed treatment strategy

53
Q

Isoniazid ADRS

A

Liver toxicity
Peripheral neuropathy
Mental Retardation
Incordination
Drug interaction-enzyme
inhibitor

54
Q

Rifampicin ADRS

A

Liver toxicity
Orange discolouration of body
fluids
Skin rashes, thrombocytopenia
Oral contraceptive failure

55
Q

Pyrazinamide ADRS

A

Liver toxicity,
Hyperuricaemia

56
Q

Ethambutol ADRS

A

Optic neuritis

57
Q

Doses of Anti- TB drugs

A

Isoniazid- 5mg/kg
Rifampicin - 10mg/kg
Pyrazinamide- 25mg/kg
Ethambutol - 15mg/kg

58
Q

how to decide if it’s active or inactive TB

A
  • Radiology not reliable
  • High ESR alone does not suggest activity
  • Clinical and microbiological
    o Sputum smear +ve for AFB
    o Symptoms
    o Progression of CXR lesions
    o New cavitations or fluid levels
    o Response to therapeutic trial
59
Q

ADRS of Streptomycin

A

Ototoxicity
Nephrotoxicity

60
Q

miliary TB spreads by

A

blood

61
Q

Symptoms of miliary TB

A

Nonspecific symptoms – fever, malaise, weight loss, cough, headache

62
Q

Signs of miliary TB

A

Normal chest, hepatosplenomegaly, choroid tubercles

63
Q

Ix findings of miliary TB

A

High ESR, pancytopenia, hyponatraemia, military mottling on CXR

64
Q

Mantoux can be negative on miliary TB

A

True

65
Q

Sputum DS is always positive in miliary TB

A

False (10% can be positive)

66
Q

additional tests done on miliary TB

A

BM, CSF cultures

67
Q

Mx of miliary TB

A

Treat on suspicion. Category I Drugs

68
Q

besides category I drugs what else can be given for acutely ill miliary TB patients

A

steroids

69
Q

atypical features are seen in …..HIV patients with TB

A

late HIV

70
Q

atypical features seen in HIV patients with TB

A

o Extra-pulmonary involvement common
o Unusual or absent radiological features
o TST positive in <40%, often mildly (<5 mm)

71
Q

Rx challenge in HIV patients with TB

A

drug resistance

72
Q

Sx of Pleural effusion in TB

A

Insidious onset – low grade fever, general ill health, night sweats, pleuritic pain, dyspnoea

73
Q

Ix findings in PE due to TB

A

High ESR, normal WCC, positive mantoux

74
Q

Pleural fluid analysis in TB

A

o Straw coloured
o High protein content
o High lymphocyte count
o AFB is often negative
o M. tuberculosis culture positive in 30%
o ADA (Adenosine deaminase) may be positive

75
Q

pleural biopsy in TB

A

caseating granuloma

76
Q

Mx on PE due to TB

A

standard category 1 treatment, a short course of steroids may be given

77
Q

Drug- resistant TB is most commonly seen in

A

More in HIV, Health care workers

78
Q

MDR TB

A

resistant to both Isoniazid and Rifampicin

79
Q

Extensive Drug Resistance(XDR) TB

A

-resistant to both isoniazid and Rifampicin with resistance to any
of the quinolones(such as levofloxacin or moxifloxacin) and atleast one of the second line injectable
drug- Kanamycin, Capreomycin, Amikacin

80
Q

second line drugs used in TB

A

Quinolone-ofloxacin,ciprofloxacin

Aminoglycoside- Kanamycin, Amikacin, Capreomycin

Para amino salicylic acid-cicloserine, Ethiopromide

Macrolide- Clarithromycin, Azithromycin

Pulmonology (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions