TB Flashcards
what are the top five countries with TB?
Ethiopia, India, Viet Nam, the Philippines, and El Salvador
How is TB transmitted? **
transmitted through Inhaled airborne droplets containing viable organisms
(ppl w active disease, talks coughs, sneezes)
how does the immune system react when TB first comes into the body?
lymph nodes wall it off, creating caseating granulomas and calcified areas (long term inflammation)
what does “caseating” look like? what is this appearance suggestive of?
cheesy material in middle suggesting destruction
of tissue on pathology
___% of people will not be successful at “walling off” the TB. it will go from primary TB to become ___________TB
5%; PROGRESSIVE PRIMARY
___% of people have latent TB after primary. What is latent TB?
95%; wall off bacilli and don’t get active infection
____% of latent TB pts will have reactivated TB
10% (pt has had TB for >2 yrs)
what populations are at risk for TB?
poorer populations, less developed countries, homeless, those on dialysis (for some reason… dont know why). etc.
calcified TB in lungs can be seen with what kind of imaging?
Chest Xray
primary TB presents how?
usually clinically silent with normal CXR
Calcified granuloma is called _______
Calcified granuloma and calcified hilar lymph node is called ____________. which of these is the more common one?
Calcified granuloma called Ghon complex (common)
Calcified granuloma and calcified hilar lymph node termed Ranke complex (not commonly seen)
what is the time period requirement between latent and reactivation?
Reactivation:
had TB for > 2 years, was latent and now active again
Clinical presentation: 3 symptom types for TB. which is the most common
pulmonary (most common), extrapulmonary and disseminated
clinical presentation- pulmonary: where is it found and what are the two characteristic presentations?
-likes O2, so its found in upper lobes
Primary or latent TB: asymptomatic
Reactivated or progressive primary: Slowly progressive malaise, anorexia, weight loss, fever, and drenching night sweats)
ALSO chronic cough: Dry, then productive then bloody
dyspnea is LATE symptom
extrapulmonary vs disseminated: where they are found and what are their clinical presentations?
Extrapulmonary: Spread through lymph or blood
Does not occur in primary – usually means reactivation TB
Disseminated (TB all throughout the body) in immunocomprimised
how does a pulmonary TB patient look on physical exam? what is the classic symptom?
Chronically ill and malnourished (b/c chronic infection is a huge metabolic demand)
Classic post-tussive rales: Crackles heard after cough (usually these are cleared with cough)
most common extrapulmonary presentation? what GU presentation? what is miliary TB?
lymphadenitis
GU TB – sterile pyuria (WBCs in urine from TB)
Miliary TB – Spread through other parts of lung through blood and not direct extension. looks like little yellow seeds or a shot-gun pattern
____ Dx is key for TB
Early diagnosis key
what is considered to make someone a high index of suspicion for TB?
bloody cough
Chest Xray for primary progressive TB will show what?
- homogenous infiltrates
- hilar and paratracheal lymph node enlargements
- segmental atelectasis
Chest Xray for reactivation TB shows what?
-Fibrocavitary apical dz
posterior segment of upper lobes or superior segments of lower lobes (O2 highest here)
what are cavitations?
looks like walled off bubbles in primary progressive and reactivation TB