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Y3(M) - Respiratory > TB > Flashcards

TB Flashcards

1
Q

What are some differentials for:
2month history of weight loss, low grade fever and Haemoptysis

A

Lung cancer
TB
PCP pneumonia
Sarcoidosis
ILD (silicosis)
Sarcoidosis

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2
Q

What type of organism is Mycobacterium tuberculosis?

A

Gram +ve acid fast rod shaped bacilli
Aerobic organism

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3
Q

Which part of the lungs does TB typically infect?

A

Apex of the lungs

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4
Q

What are the 3 causes of homogenous opacity on plain chest radiograph?

A

Fluid
Lung collapse
Solid mass like tumour

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5
Q

How is TB transmitted?

A

DROPLET TRANSMISSION

Overcrowding
Poor sanitation
Poor ventilation
Spitting in public

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6
Q

What are the risk factors for catching TB

A

Overcrowding
Poor sanitation
HIV
Malnourishment
Alcoholism
Chronic steroid use
Chemotherapy
Anti-TNF (infliximab)
Malignancy

Anything that causes Immunosupression

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7
Q

What is the clinical presentation of TB infection?

A

Chronic productive cough
Low grade
Fever
Weight loss
Haemoptysis

Systemic features

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8
Q

What systemic complications can TB cause ?

A

Intestinal TB
Genitourinary TB
TB ascites

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9
Q

What are stages of infection of TB?

A

Most peoples innate immunity clear the infection
Immunocompromised get infection
If TB is contained = LATENT TB
If not cleared becomes PRIMARY TB INFECTION

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10
Q

What happens if a patient becomes immunocompromised with latent TB?

A

Develops to secondary TB

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11
Q

How does the immune system contain TB causing latent TB?

A

Forms granulomas

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12
Q

What is the name of the structure which shows up on chest X-ray with latent TB?

A

Ghons complex
Ghons focus

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13
Q

What is a Ghons complex?

A

When granuloma spreads to the hilar lymph nodes so you can see consolidations

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14
Q

What is considered disseminated TB?

A

When theres infection of 2 or more non contiguous sites

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15
Q

What will the results be for a skin prick test if a patient has latent TB?

A

+ve skin prick test

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16
Q

What investigations would you do for a patient presenting with a 2month history of cough, weight loss and low grade fever?

A

SPUTUM SAMPLE
FBC
U+E
LFT
CRP
INR

HIV serology
Hepatitis serology
HbA1c
Blood glucose

17
Q

What imaging is first used if you want to investigate chronic cough, weight loss and low grade fever?

A

CXR

18
Q

What investigations are done on the sputum sample for chronic cough, weight loss and low grade fever?

A

MC and histology
NAAT (Nucleic Acid Amplification Test)

19
Q

What is the utility of using gene xpert on the sputum sample when assessing TB?

A

Checks the TB resistance for the TB agent Rifampicin

20
Q

What are the 4 key antibiotics for treating TB infection?

A

Rifampicin
Isoniazid
Pyrazinamide
Ethambutol

21
Q

What is the regime for antibiotics for a non CNS involved TB infection?

A

2months of: Rifampicin + Isoniazid + Pyrazinamide + Ethambutol

Then

4months: Rifampicin + Isoniazid (?pyrazinamide)

22
Q

What supplement do you also give to the patient when treating them for TB and why?

A

Pyridoxine (Vit B6)

Isoniazid causes peripheral neuropathy

23
Q

What conservative changes do you encourage a patient to do while they’re being treated for TB?

A

Encourage high protein diet

24
Q

What additional mediations do you give to a patient with CNS involved TB infection?

A

Steroids
Anti-epileptics

25
Q

What are the main side effects of Rifampicin?

A

ORANGE URINE/BODILY SECRETIONS
DRUG INDUCED HEPATITIS
Gastritis
Vomiting
Thrombocytopenia

26
Q

What are the main side effects of Isoniazid?

A

DRUG INDUCED HEPATITIS
PERIPHERAL NEUROPATHY

27
Q

What are the main side effects of Pyrazinamide?

A

GOUT/HYPERURICAEMIA
HEPATOTOXIC

28
Q

What are the main side effects of Ethambutol ?

A

OPTIC NEURITIS
COLOUR BLINDNESS

29
Q

What monitoring needs to be regularly done when treating someone for TB and why?

A

Regular LFT monitoring
Rifampicin hepatotoxic
Isoniazid hepatotoxic
Pyrazinamide hepatotoxic

Y3(M) - Respiratory (6 decks)

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