TB and AIDS Flashcards
Mainstay of diagnosis of Primary TB
Chest radiograph
Most common form of PTB in infants and children under 5 years of age
Primary TB
4 Manifestations of TB
Parenchymal disease
Lymphadenopathy
Miliary Bodies
Atelectasis
Dense, homogenous consolidation, Indistinguishable from bacterial pneumonia, predominance lower and middle lobes ( adult) middle and upper (children)
Parenchymal disease
Difference Parenchymal disease and bacterial pneumonia
Lymphadenopathy and lack response antibiotics PD
Greatest ventilation area (3)
Lower, middle, and anterior upper lobe
Radiologic scar that persist, 15 % calcify
ghon focus
Mostly lymphadenopathy is
A. Bilateral R and L sided
B. Unilateral L sided
C. Unilateral R sided
C. Hilum and R paratracheal region
A. One third cases
In Ct scan active disease primary TB present as (2)- lymphadenopathy
> 2 diameter
Low attenuation center 2nd to necrosis
Maybe the sole radiograph feature
Lymphadenopathy
Mainstay of diagnosis of lymphadenopathy
CT scan
Ghon complex + calcified lymph node, suggestive of previous TB
Ranke Complex
Elderly, infants and immunocompromised person. Manifesting w/in 6 months exposure
Miliary TB
Mainstay of diagnosis of miliary TB
CT scan
Radiographic findings in miliary TB
Hyperinflation- earliest feature
Evenly distributed diffuse small 2-3mm nodules
Slight lower lobe predominance
Complex septated effusion ultrasound
Pleural effusion
Re infection with reactivation of TB, common in adolescence and adulthood
Postprimary TB
Hallmark of Postprimary TB, thick, irregular walls which become smooth and thin with successful treatment
Cavitation
Postprimary TB location.
Bilateral upper lobe fibrosis
Manifestation of Postprimary TB
Parenchymal disease
Airway involvement
Pleural extension
Earliest finding in Parenchymal disease
Patchy, poorly defined consolidation
Tree in bud sign, visible in the lung periphery
Active TB (Postprimary TB) Parenchymal disease
Lobar collapse or hyperinflation. Obstructive pneumonia. Mucoid impaction.
Bronchial stenosis
What imaging is this/kind. Long segment narrowing with irregular wall, thickening, luminal obstruction, and extrinsic compression.
CT scan. Airway involvement Postprimary TB
Most common manifestation of CNS tuberculosis across all age group. Secondary to rupture of rich focus occuring on the cortex of the brain that ruptures into the subarachnoid space.
Tuberculous Meningitis
Gadolinium- enhanced MRI > CT scan. Abnormal meningeal enhancement, most pronounced in the basal cisterns.
Radiographic Findings in tuberculous meningitis
Complication of tuberculous meningitis
Communicating hydrocephalus (blockage of basal cisterns)
Ischemic infarcts
Cranial nerve involvement(2,3,4,7)
Most common CNS parenchymal lesion.
Solitary, multiple, miliary
Frontal and parietal
Tuberculoma
Most common location of head and neck TB
Neck nodes
Bilateral painless cervical lymphadenitis in head and neck TB
Scrofula
Central hypo intensity and hyper intensity on T1 and T2 weighted MR images, respectively.
MRI head and neck TB
Most commonly affects (musculoskeletal TB). Affects all ages
Spinal column, pelvis, knees
Diagnosis. Average delay of 16-19 months between the onset of symptoms and reported diagnosis. History of infection with or exposure to tuberculosis may be present. Concurrent active intra thoracic tuberculosis (
Musculoskeletal tuberculosis
Hematogenous spread via the venous plexus of Batson. Infection usually begins in the anterior part of the vertebral body adjacent to the end plate. Lower thoracic and upper lumbar in location
Tuberculous Spondylitis
Spread of infection into the para spinal tissues. Calcifications of the abscess. Diagnostic of TB.
Pott abscess (Tuberculous Spondylitis )
Left untreated. Vertebral collapse and anterior wedging leading to kyphosis.
Gibbus formation (Tuberculous Spondylitis )
Anterior scalloping. Involvement of one or more segments. Destruction of intervertebral disks. Calcified vertebral mass. Absence of sclerosis. Rarely affects the posterior vertebral elements.
MRI of Tuberculous Spondylitis
CT is the modality of choice. Most common focus of extra pulmonary TB.
Abdominal TB
Most common manifestation of abdominal TB. 55%-66% of patients. Mesenteric and peri pancreatic lymph node group enlargement .
Abdominal lymphadenopathy
Earliest manifestation : Spasm and hyper mobility with edema of the valve . Thickening of an incompetent ileocecal valve
Barium enema- abdominal TB
Most common CT scan finding: Concentric mural thickening.
Gastrointestinal tuberculosis
Extrinsic compression at the level of the carina from lymphadenopathy
Esophageal tuberculosis
Usually affects the Antrum and the distal body. Can simulate peptic ulcer disease. Sinus or fistula formation.
Gastric tuberculosis
Nonspecific mucosal fold thickening. (Other GI TB)
Proximal small bowel tuberculosis
5th most common site of extra pulmonary TB. 6% of patients with active TB. CT scan findings: Bilaterally enlarged glands associated with large hypo attenuating necrotic areas, with or without calcifications.
Adrenal tuberculosis
Most common clinical manifestation of extra pulmonary tuberculosis. Hematogenously ( prostate gland, seminal vesicles, and kidneys). Direct extension ( bladder o epididymis )
Genitourinary tuberculosis
Earliest abnormality= “ moth- eaten calyx” can be seen in IV urography this is due to erosions which progresses to papilliary necrosis
Renal tuberculosis
CT scan. Hypoattenuating center and hyperattenuating enhancing rim
Tuberculous lymph nodes
Demonstrates a thickened and deformed bladder with enhancing wall
Bladder TB
Characterized by opportunistic infections, neoplasm and neurological manifestations.
AIDS
Most common cause of cerebral abscess
Cerebral toxoplasmosis
“Sandwich sign”
Gastric lymphoma
Distal third of the ureter is most commonly involved. Stricture predilections pelviureteric junctio, across the pelvic brim, vesicoureteric junction.
Ureteric tuberculosis
CT scan. It appears as round or lobulated masses with low or high attenuation, homogenous or ring enhancement, irregular walls of varying thickness. TARGET SIGN
Tuberculoma
