TB Flashcards

1
Q

What causes TB?

A
  • M. tuberculosis

* M. bovis

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2
Q

What is the pathology of TB?

A

Primary infection

  • Localised lung lesion
  • Heals with development of specific immunity
  • Asymptomatic in 90% of patients
  • Can be haematogenous spread

Post-primary disease

  • Reactivaton of persisting mycobacteria
  • Much greater immune response
  • Usually symptomatic
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3
Q

What is active TB?

A
  • Containment by the immune system is inadequate

- Can arise from primary infection or latent infection

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4
Q

What is latent TB?

A
  • Infection without disease due to immune system containment -> granuloma formation - Contains bacterial growth and spread
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5
Q

What are the systemic symptoms of TB?

A
  • Weight loss
  • Night sweats
  • Anorexia
  • Fevers
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6
Q

What are the pulmonary symptoms of TB?

A
  • Cough +/- sputum

- Haemoptysis

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7
Q

What are the lymph node symptoms of TB?

A
  • Painless lymphadenopathy

- Node is firm and not acutely inflamed

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8
Q

What are the pleuritic symptoms of TB?

A

Pleuritic pain

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9
Q

What are the bone symptoms of TB?

A
  • Progressive bone/joint pain

- Swelling

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10
Q

What are the GI symptoms of TB?

A
  • Colicky abdominal/pelvic pain
  • Constipation
  • Vomiting
  • Bowel obstruction (bowel wall thickening)
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11
Q

What are the genitourinary symptoms of TB?

A
  • Sterile pyuria (white cells in urine and absence of bacteria)
  • Dysuria
  • Frequency
  • Loin pain
  • Haematuria
  • Strictures
  • Infertility
  • Gential ulceratiob
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12
Q

What are the CNS symptoms of TB?

A
  • Headache
  • Vomiting
  • Irritability
  • Confusion
  • CN abnormalities
  • Meningitis
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13
Q

What are the cardiac symptoms of TB?

A
  • Pericarditis

- Pericardial effusion +/- constrictive pericarditis

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14
Q

What are the skin symptoms of TB?

A
  • Erythema nodosum

- Lupus vulgaris

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15
Q

What would a CXR show in primary disease?

A
  • Primary focus
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16
Q

What would a CXR show in post-primary disease?

A
  • Upper lobe consolidation
  • Apical segment lower lobe
  • Cavitation
  • Volume loss
  • Lymphadenopathy
  • Pleural effusion
  • Pneumothorax
  • Miliary TB
17
Q

What is miliary TB?

A

• Haematogenous dissemination leads to the formation of discrete foci (millet seeds) uniformly distributed throughout the lung fields

18
Q

What investigations would you do for TB?

A
  • CXR
  • ESR/CRP
  • HIV test
  • LFTs
  • Sputum culture
  • Ziehl-Neelsen Stain
  • Serous fluid cytology
  • PCR
  • Urinalysis
19
Q

Why would you look at LFTs in TB?

A

Medications are hepatotoxic so need a baseline before starting treatment

20
Q

How would you detect latent TB?

A
  • BCG scar
  • Mantoux test
  • Interferon gamma releasing assay (IGRA)
  • CXR
21
Q

Who is required to be screened for TB before coming into the UK?

A

People from a high-risk country who apply for a UK visa for > 6 months

22
Q

Who cannot have the BCG vaccine?

A
  • Immunocompromised

- HIV +ve patients