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LC Respiratory week 4 > TB > Flashcards

TB Flashcards

1
Q

Where is TB most common on an X-ray?

A

Upper zones

right

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2
Q

How is TB spread?

A

Airborne spread of mycobacterium TB

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3
Q

How is it usually cured?

A

By 6 months of antibiotics

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4
Q

What happens after exposure to TB?

A

Most people will clear the TB by the innate or acquired immune response.
Other people will be infected. Half of them will be fine and have TB infection, other people will actually have TB disease.

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5
Q

What does the body do with the TB?

A

It is taken in by the macrophage and the body seals it off in a granuloma.

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6
Q

When do people get active disease?

A

When the granuloma that the TB is in, cant hold it back anymore and the TB spreads everywhere

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7
Q

Name some general clinical features of TB?

A

Weight loss, malaise, night sweats

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8
Q

Name some respiratory clinical features of TB?

A

Cough, Haemoptysis, breathlessness, upper zone crackles

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9
Q

Name some meningeal clinical features of TB?

A

Headache, drowsy, fits

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10
Q

Name some GI clinical features of TB?

A

Pain, bowel obstruction, perforation, peritonitis

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11
Q

Name some spinal clinical features of TB?

A

Pain, deformity, paraplegia

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12
Q

What is a cold abscess and can you get them in TB?

A

are collections of pus without the pain and acute inflammation seen in a conventional abscess.

You can get them in TB

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13
Q

How can you test for TB?

A

ZN stain - due to TBs thick waxy coat (hangs onto the stain)
PCR - sputum sample. Takes 2 hours and also tells you if organism is resistant to rifampicin

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14
Q

Name some histological features of TB?

A

Multinucleate giant cell granulomas

Caseating necrosis

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15
Q

What are some radiological features of TB?

A 
Upper lobe predominance 
Cavity formation 
Tissue destruction 
Scarring and shrinkage 
Heals with calcification
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16
Q

How do you get miliary TB?

A

Massive seeding of mycobacteria through the bloodstream. Untreated it can be rapidly fatal.

17
Q

What is the treatment for TB?

A 
2 RIPE 4 RI 
Rifampicin 
Isoniazid 
Pyrazinamide 
Ethambutol
18
Q

What are some of the side effects of the TB medications?

A

Rifampicin - turns bodily fluids orange

Ethambutol - optic neuritis

19
Q

Why do you need to treat TB for so long?

A

As there are replicating and NON-replicating TB bacilli

20
Q

What is the most commonly TB drug that there is resistance to?

A

Isoniazid

21
Q

What is commonly the MDR (multi-drug resistance) in TB?

A

Isoniazid and rifampicin

22
Q

Describe latent TB?

A

Symptom free
Culture negative
It is a balance between the organisms and your immune system.
Between a quarter and a third of the worlds population has latent TB

23
Q

Name some evidence that would indicate previous TB infection?

A

History of TB prior to 1960
Calcification on x-ray
Exposure to High Prevalence area

24
Q

What tests can you do to test for previous exposure?

A

Interferon gamma release assay (blood test)

Mantoux (tuberculin) test (skin test) - also detects exposure to BCG

25
Q

What is tuberculin?

A

It is a protein derived from the culture of mycobacteria. Used as a diagnostic agent.

It is only used as a diagnostic agent. 0.1ml of the solution is injected intradermally. The patient has to return at least 48 hours later to see if there has been a delayed hypersensitivity reaction at the site of injection.

26
Q

How does Interferon gamma release assay (blood test)

work?

A

IGRA tests are performed on blood samples. The assay looks for interferon gamma specific to antigens found only in m.tuberculosis. It does not react with BCG which is an attenuated strain of m.bovis.

27
Q

How might you prevent TB?

A

Screening of high risk subgroups
BCG immunisation
Social aspects - housing, nutrition

28
Q

Describe BCG immunisation?

A

Attenuated strain of mycobacterium bovis
Intradermal injection
Most effective in neonates of high risk families
Also provides some protection against leprosy

29
Q

What is a high risk for TB?

A

if you have HIV

30
Q

What drugs can reactivate latent TB?

A

Steroids and immunosuppressant drugs

LC Respiratory week 4 (6 decks)

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