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Conditions: Respiratory > TB > Flashcards

TB Flashcards

1
Q

What statistic is significant about TB?

A
  • Second leading cause of death from an infectious disease
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2
Q

How does TB proliferate the formation of granuloma?

A
  • Activation of macrophages
  • Epitheliod cells
  • Langhans giant cells form
  • Accumulation = granuloma
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3
Q

What can the granuloma cause?

A
  • Central caseating necrosis
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4
Q

What can occur to the central caseating necrosis if left untreated?

A
  • Can calcify
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5
Q

What can TB do in susceptible hosts?

A
  • Tissue destruction
  • Proliferation of other organisms
  • Progressive disease
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6
Q

Where does lymphatic spread of TB occur?

A
  • Lungs
  • Bones
  • Genitourinary system
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7
Q

What are the initial symptoms of TB?

A

Usually none

  • Fever
  • Malaise
  • Erythema nodosum
  • Chest signs (rare)
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8
Q

What are the symptoms following primary pulmonary TB?

A

Usually none but

  • Fever
  • Malaise
  • Cough
  • Sputum
  • Haemoptysis
  • Pleuritic pain
  • Dyspnoea
  • Weight loss
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9
Q

What are the signs are primary pulmonary TB?

A
  • Erythema nodusum
  • Crackles
  • Bronchial breathing
  • CAN HAVE FINGER CLUBBING BUT VERY RARE
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10
Q

What are the risk factors of TB?

A
  • Malnutrition
  • Dependent age
  • Diabetes
  • Immunosuppression
  • Previous TB
  • Alcohol
  • IVDA
  • Poor social class
  • Immigrant from high incidence areas
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11
Q

What are the two common organisms that cause TB?

A
  • Mycobacterium TB

- Mycobacterium bovis

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12
Q

How is mycobacterium TB diagnosed?

A
  • Needs to grow first

- Can’t be identified until then

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13
Q

What does myco mean?

A
  • Fungus
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14
Q

How do mycobacterium TB and bovis spread between hosts?

A
  • Droplets

- Can remain airborne for a long time

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15
Q

What is performed first in screening for TB?

A
  • Heaf test

- Mantoux test

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16
Q

What is the mantoux test?

A
  • Injection of tuberculoprotein
  • Results in lymphocytic/macrophage accumulation in administered site
  • If no such recruitment occurs test is negative
17
Q

What other diagnostic test is there for TB?

A

3 sputum specimens on successive days

  • Sputum smear (ziehl nielsen stain)
  • Sputum test
  • Sputum PCR
18
Q

What will be the findings on a CXR of a TB sufferer?

A
  • Patchy shadowing on apices/upper zones
  • Apex of lower zones can be affected
  • Often bilateral
  • Cavitation if advanced TB
  • Calcification possible if chronic/healed
19
Q

If sputum tests are negative what is the next step?

A
  • CT scan of thorax
  • Bronchoscopy
  • Pleural aspiration/biopsy
20
Q

How would a bronchoscopy be performed?

A
  • Broncheoalveolar samples + biopsy
  • Z-N stain
  • Culture
  • PCR
  • Histology
21
Q

What others tests should be done with TB?

A
  • HIV tests
22
Q

What should be done to people in close contact to the patient?

A
  • Should all be screened as 1 in 6 will develop disease
23
Q

What type of treatment should be followed for TB?

A
  • Multiple drug treatment along with santorium regime
24
Q

What happens if you use single drug treatment for TB?

A
  • Rapid resistance
25
Q

How long is therapy continued for?

A
  • 6 months
26
Q

When is the TB rendered non infectious?

A
  • 2 weeks after start of treatment
27
Q

What drugs should be used for 2 months with TB?

A
  • Rifampicin
  • Isoniazid
  • Ethambutol
  • Pyrazinamide
28
Q

What are the side effects of rifampicin?

A
  • Orange tears
  • Liver enzymes affected
  • Hepatitis
  • Oral contraceptive ineffective
29
Q

What are the side effects of isoniazid?

A
  • Hepatitis

- Peripheral neuropathy

30
Q

What are the side effects of ethambutol?

A
  • Optic neuropathy
31
Q

What are the side effects of pyrazinamide?

A
  • Gout
32
Q

What drugs are used for the last 4 months?

A
  • Rifampicin

- Isoniazid

33
Q

What percentage of TB infection is primary infection?

A
  • 80%
34
Q

Where do mycobacterium spread first in TB?

A
  • Hilar lymph nodes
35
Q

From the hilar lymph nodes where can mycobacterium spread?

A
  • Can seed all organs of the body

- Can calcify but often heals without a scar

36
Q

What can occur with progression of the disease 6-12 months following infection?

A
  • Miliary TB
  • Meningeal TB
  • Pleural effusion

Conditions: Respiratory (16 decks)

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