TB

Question 1

Histologically description of primary TB

Answer 1

CASEATING granulomas

surrounded by epitheloid and Langerhans giant cells

Question 2

Drugs taken for TB

Answer 2

2 months of RIPE
4 months of RI

Rifampicin
Isoniazid
Pyrazinamide
Ethambutol

Question 3

What causes TB? How does it appear microscopically?

Answer 3

Mycobacterium tuberculosis

Acid fast bacilli

Question 4

What is a ghon focus?

Answer 4

Initial caseating granuloma from primary infection

Question 5

What defines miliary TB?

Answer 5

When immune system cannot cope with disease - it causes disseminated

Question 6

How can it present dermatologically?

Answer 6

Erythema nodsum

Question 7

Buzzword symptom

Answer 7

Night sweats

Question 8

What tests can be used to identify an immune response to TB?

Answer 8

Mantoux test

Postive mantoux and ?latent = IGRA (interferon gamma release array)

Question 9

What stain is used to identify mycobacterium tuberculosis?

Answer 9

Zeihl-Neelsen

Red against blue background

Question 10

How many sputum samples MUST be collected?

Answer 10

3

Can be induced if necessary using saline solution

Question 11

How does miliary TB appear on CXR?

Answer 11

Millet seeds

Widespread consolidation

Question 12

If risk of reactivation of latent TB what treatment can be used?

Answer 12

3 months of RI

OR

6mnths of I

Question 13

Side effects of TB medication

Answer 13

Rifampicin - red/orange secretions (red n orange pissing)

Isoniazid - peripheral neuropathy (i’m so numb-azid)

Pyrazinamide - gout

Ethambutol - colour blindness (E =eyes)

Question 14

they are started on R, I, P and E what should also be prescribed?

Answer 14

Pyridoxine - reduces chance of isoniazid induced neuropathy

Question 15

What vaccination is given to provide immunity?

Answer 15

BCG

Question 16

What cell type will usually internalise the tubercule bacillus?

Answer 16

Macrophage