TB Flashcards
What is secondary TB?
Illness due to dormant bacilli and frequent cavities
What is primary TB?
Illness directly after infection
What is a lung abcess?
Collection of pus inside a cavity
What are your differentials for night sweats?
Infectious
- IE
- TB
- OM
- abcess
- HIV
- viral, fungal, parasitic
NEOPLASTIC
Hodgkins
Non-hodgkins
CML
Iatrogenic
- antidepressants
- antipyretics
What pathogen causes TB and what is the route of transmission?
Mycoplasma tuberculosis
Airway droplets
Risk factors for TB?
HIV biggest single risk factor
Crowded living conditions
Migrants
Indigenous/ TSI
Healthcare workers
Sx?
Insidious onset
Fever, night sweats
Wt loss, anorexia, fatigue
Malaise, weakness
Resp
Cough, chest pain, HAEMOPTYSIS
Where can extra pulmonary tb occur?
Lymph nodes (esp in HIV)
- painless lymphadenopathy
- diagnose by fna/surgical biopsy
Pleural effusions
- thoracocentesis and pleural fluid MCS
- Rx: chemotherapy
Bone and joint
- wt bearing joints
- Ix ct or MRI
- Rx with chemo
What investigations tb?
CBE EUC LFT
- mild anemia and leukocytosis
Sputum MCS including acid-fast bacilli
- 3 consecutive morning
- +ve indicates mycobacterium but not m. Tuberculosis
HIV ELISA +/- western blot
BGL for DM
Biopsy for histology
Radiology
CXR
- primary: hilarious lymphadenopathy
- post-primary: cavity in upper lobe and pleura effusion
CT xray, IV pyelogran for extra pulmonary disease
Investigations for latent TB?
Tubuculon skin test
Interferon gamma release assays
Rx?
Isoniazid 6 months - peripheral neuropathy
Rifampicin 6 months - hepatotoxicity
Pyrazinamide for 2 months
- thrombocytopenia
Ethambutol for 2 months - optic neuritis
Can use corticosteroids if complicated
Do you treat contacts?
Yes to prevent primary infection or deactivation
Isoniazid for 6-12 months
Complications of TB?
Military TB
TB pneumonia
TB empyema massive HAEMOPTYSIS
