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Pediatrics Respiratory > TB > Flashcards

TB Flashcards

1
Q

Most common causative organism of TB

A

Mycobacterium tuberculosis

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2
Q

What is the main causative organism of pulmonary tuberculosis?

A

Mycobacterium tuberculosis

Other organisms include mycobacterium bovis and mycobacterium africanum.

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3
Q

How is pulmonary tuberculosis primarily transmitted?

A

By inhalation or ingestion.

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4
Q

What is the most common site of primary infection in pulmonary tuberculosis?

A

Lung (98%).

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5
Q

List other sites where primary infection of tuberculosis can occur.

A
  • Skin
  • Tonsils
  • Intestine
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6
Q

What are the components of the primary pulmonary complex?

A
  • The primary focus (Ghon’s focus)
  • Lymphangitis
  • Regional lymphadenitis
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7
Q

What is the fate of the primary complex in tuberculosis?

A
  • Healing by fibrosis and calcification
  • Spread of infection
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8
Q

What are the local spread conditions of post-primary tuberculosis?

A
  • T.B. pneumonia
  • T.B. pleurisy
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9
Q

What is a possible complication of pleural effusions in tuberculosis?

A

Hypersensitivity reaction.

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10
Q

What can result from bronchial spread of tuberculosis?

A
  • Bronchopneumonia
  • Collapse of the lung
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11
Q

What does blood spread in tuberculosis lead to?

A
  • Miliary T.B.
  • Distant spread (e.g., T.B. meningitis)
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12
Q

What are common symptoms of pulmonary tuberculosis?

A
  • Night fever
  • Night sweats
  • Loss of weight
  • Loss of appetite
  • Chronic cough
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13
Q

What characterizes the chronic cough in tuberculosis?

A

Purulent, mucoid, or bloody sputum.

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14
Q

What signs are associated with pneumonic lesions in tuberculosis?

A

Signs of consolidation.

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15
Q

What signs indicate pleural effusion in tuberculosis?

A

Signs of effusion.

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16
Q

What occurs in fibrosis related to tuberculosis?

A

Deviation of the trachea and mediastinum to the same side.

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17
Q

What happens when tuberculous lymph nodes compress the trachea and bronchi?

A

Wheezes.

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18
Q

True or False: Chronic cough is the main symptom of pulmonary tuberculosis.

A

True.

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19
Q

Fill in the blank: The small caseous focus in the lung parenchyma due to the union of multiple tubercles is known as _______.

A

Ghon’s focus.

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20
Q

What is lymphocytosis in the context of CBC?

A

An increase in lymphocytes in a complete blood count

Lymphocytosis can indicate various conditions, including infections and certain leukemias.

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21
Q

What is the significance of a very high ESR in pediatric diagnostics?

A

An ESR usually above 100 indicates inflammation or infection

An elevated ESR can be seen in various conditions, including autoimmune diseases and infections.

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22
Q

What types of tests are used for cell-mediated response in tuberculosis diagnosis?

A
  • Tuberculin test
  • Quantiferon TB test

These tests help assess an individual’s immune response to tuberculosis.

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23
Q

How is sputum obtained for tuberculosis investigations?

A

Through gastric aspirate

This method is used particularly in pediatric patients who may not be able to produce sputum.

24
Q

What staining method is used for direct smear in tuberculosis diagnosis?

A

ZN stain

ZN stands for Ziehl-Neelsen, a method used to stain acid-fast bacilli.

25
Q

What is the incubation period for culture on Lowenstein Jensen medium?

A

4 weeks

This medium is selective for the growth of Mycobacterium tuberculosis.

26
Q

How long does BACTEC culture take for tuberculosis diagnosis?

A

10 days only

BACTEC is a rapid culture method that allows for quicker diagnosis of tuberculosis.

27
Q

What serological tests are used in tuberculosis diagnosis?

A
  • ELISA
  • PCR

ELISA detects antibodies, while PCR detects T.B. DNA.

28
Q

What is the purpose of a lymph node biopsy in tuberculosis cases?

A

To diagnose undiagnosed cases of tuberculosis

A biopsy can provide definitive evidence of infection.

29
Q

What is the purpose of a chest X-ray in tuberculosis diagnosis?

A

To visualize lung abnormalities associated with tuberculosis

Chest X-rays can show signs of TB infection, such as cavitations or nodules.

30
Q

What is the Mantoux test used for?

A

To assess exposure to tuberculosis

The Mantoux test involves intradermal injection of PPD and measuring the induration.

31
Q

What is the intradermal dose for the tuberculin injection?

A

0.1 ml (10 units) of purified protein derivative (PPD)

The injection is administered into the flexor surface of the forearm.

32
Q

What does a positive reaction (> 10 mm) in the Mantoux test indicate?

A

Either BCG vaccination or tuberculosis infection if not vaccinated

A positive reaction requires further investigation to determine the cause.

33
Q

What does a reaction greater than 15 mm in the Mantoux test indicate?

A

Infection

A vaccine response never exceeds 15 mm in diameter.

34
Q

In the Mantoux test, how is the induration assessed?

A

Measure the average diameter of the induration, not the redness

The measurement is taken at 48-72 hours after injection.

35
Q

What are some causes of false-negative tuberculin tests?

A

False-negative tuberculin tests can occur due to:
* Early disease: Before immunological response
* Advanced disease: Miliary T.B.
* Poor tuberculin quality
* Faulty technique (S.C. injection)
* Corticosteroid administration
* Chronic debilitating disease, cachexia, and immunodeficiency
* Recent antiviral vaccine (especially measles and mumps)
* Inter-current viral infection

These factors can compromise the accuracy of the tuberculin skin test.

36
Q

What can cause false-positive tuberculin tests?

A

False-positive tuberculin tests can occur due to:
* BCG vaccine
* Infection with atypical mycobacteria (e.g., leprosy)

These conditions can lead to a positive reaction despite the absence of active tuberculosis.

37
Q

What are the typical findings on a chest X-ray for tuberculosis?

A

Chest X-ray findings for tuberculosis may include:
* Mediastinal lymph nodes
* Miliary shadows
* Persistent shadows

These findings are important for diagnosing and monitoring tuberculosis.

38
Q

What is the role of chest X-ray and CT in tuberculosis?

A

Chest X-ray and CT are used to:
* Show mediastinal lymph nodes
* Identify miliary shadows
* Detect persistent shadows
* Conduct mass screening for TB

Imaging techniques are essential for the early detection and management of tuberculosis.

39
Q

List general measures for the prevention of tuberculosis.

A

General measures for tuberculosis prevention include:
* Good nutrition
* Good housing
* Better aeration
* Elimination of TB in cattle
* Pasteurization of milk
* Mass radiography centers for early detection
* Repeated examination of employees dealing with children

These measures aim to reduce transmission and improve public health.

40
Q

What is the recommended dose of isoniazid for chemoprophylaxis in children with prolonged contact with open TB cases?

A

The recommended dose of isoniazid for chemoprophylaxis is:
* 15 mg/kg/day for 6 months to 1 year

This treatment is important for preventing the development of active tuberculosis in at-risk children.

41
Q

True or False: BCG vaccination can lead to a false-positive tuberculin test.

A

True

BCG vaccination is known to cause a positive reaction in tuberculin skin tests.

42
Q

Fill in the blank: Good nutrition, good housing, and better _______ are general measures for tuberculosis prevention.

A

aeration

These factors contribute to reducing the risk of tuberculosis transmission.

43
Q

What is the first-line antituberculous drug?

A

Isoniazid (INH)

Isoniazid is one of the primary medications used in the treatment of tuberculosis.

44
Q

Name three first-line drugs used in tuberculosis treatment.

A
  • Isoniazid (INH)
  • Rifampicin (RIF)
  • Pyrazinamide (PZA)

These drugs are essential components of the standard tuberculosis treatment regimen.

45
Q

What is the dosage range for Isoniazid?

A

10 - 15 mg/kg/day orally

Isoniazid is typically administered in this dosage range depending on the patient’s weight.

46
Q

What are the alternative drugs for tuberculosis treatment?

A
  • Streptomycin (STM)
  • Ethambutol (ETB)
  • Ethionamide (ETH)
  • Kanamycin
  • Amikacin
  • Para-amino salicylic acid

These drugs may be used when first-line treatments are not suitable.

47
Q

What is the standard treatment regimen duration for tuberculosis?

A

6-9 months

The treatment typically starts with an intensive phase followed by a continuation phase.

48
Q

What is the initial treatment phase for tuberculosis?

A

2 months of INH, RIF, and PZA

This combination is used to rapidly reduce the bacterial load.

49
Q

How long is the continuation phase of tuberculosis treatment?

A

4 months of INH and rifampicin

This phase helps to eliminate any remaining bacteria.

50
Q

Indications for steroids in tuberculosis include:

A
  • Exudative forms: pleurisy, pericarditis, ascites
  • Endobronchial TB
  • Allergy to antituberculous drugs
  • After removal of cervical lymph node to avoid fistula
  • In TB meningitis for 1 month

Steroids are used to manage complications and inflammation associated with tuberculosis.

51
Q

True or False: Treatment of TB meningitis requires a longer course of anti-TB medication.

A

True

TB meningitis is a severe form of tuberculosis that necessitates extended treatment.

52
Q

What is the dosage for Rifampicin?

A

10 - 20 mg/kg/day orally

Rifampicin is often given in this dosage range based on the patient’s weight.

53
Q

What is the dosage for Pyrazinamide?

A

20 - 40 mg/kg/day orally

Pyrazinamide is typically administered within this range for effective treatment.

54
Q

What is the dosage for Ethambutol?

A

15 - 20 mg/kg/day orally

Ethambutol is given at this dosage to ensure efficacy against tuberculosis.

55
Q

Fill in the blank: In military tuberculosis, steroids are indicated for _______.

A

[specific symptoms or complications]

The use of steroids in military tuberculosis is aimed at managing severe manifestations.

Pediatrics Respiratory (1 decks)

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