TB

Question 1

Stem; young lady came back from a foreign travel (Bangladesh) with cervical lymphadenopathy, loss of weight, and night sweats.

Q1. What are your two main differentials?

Answer 1

Lymphoma and TB

Question 2

Q2: Which lymphoma do you suspect?

Answer 2

Hodgkin

Question 3

Q3. Which labs will you send her sputum to?

Answer 3

Microbiology and Cytology

Question 4

Q4. What 2 rapid tests for TB will you do?

Answer 4

Mantoux test, PCR

Question 5

Q5. Where will you put the specimen?

Answer 5

– Yellow bag Labeled Category-B UN3373

Question 6

Q6. Organism of TB?

Answer 6

Mycobact. TB / Mycobact. Bovis / Mycobact. Avuim

Question 7

Q7. What Mycobacteria is found in immunocompromised patients?

Answer 7

M. Avuim intracellular

Question 8

Q8. How long does it take to cultures?

Answer 8

6-12 wks

Question 9

You are given the FNAC results (necrotic tissue, histocytes, giant cells)

Q9. What is your diagnosis?

Answer 9

TB

Question 10

Q10.What type of protein deposition is seen in TB?

Answer 10

Amyloid AA (as it’s chronic inflamm. Dis)

Question 11

Q11.What are giant cells?

Answer 11

Multinocuated large cells from fusion of macrophages

Question 12

Q. Pathological immune response ?

Answer 12

Type IV Hypersensitivity

Question 13

Q12:Surgically relevant examples of granuloma?

Answer 13

Sarcoidosis / Crohn’s Dis and Fungal inf. / Foreign body

Question 14

Q13. If this lady diagnosed with TB, what is the next step?

Answer 14

1- Notify the consultant in communicable disease control (CCDC)
2- Avoid working in the food factory
3- Use mask during sneezing or coughing
4- DOTS (Directly Observed Treatment, Short-course) anti-TB therapy
5- Contact tracing: the identification and diagnosis of persons who may have come into contact with an infected person for the past 21 days.

Question 15

Q.Stain for acid fast bacilli?

Answer 15

Z-N stain /
Other stains like; auramine stain