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Respiratory > TB and Pleural Infection > Flashcards

TB and Pleural Infection Flashcards

1
Q

What would white on a lung CXR indicate?

A

Mass, fluid, lung

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2
Q

How could you tell the difference between TB and lobar pneumonia on a CXR?

A

lobar pneumonia doesn’t go to the top?

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3
Q

Which lung problems go to top of lungs?

A

Airborne diseases eg. TB

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4
Q

What are TB granuloma walls like?

A

Thickened

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5
Q

When does TB cause pulmonary disease?

A

if the granuloma bursts

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6
Q

how many people infected with TB have primary tuberculosis?

A

5%

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7
Q

What are the clinical features of TB?

A 
weight loss
malaise
night sweats
cough
heamoptysis
breathlessness
upper zone crackles
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8
Q

what symptoms are linked to meningeal TB?

A

Headache. drowsy, fits

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9
Q

what are symptoms of GI TB?

A

Pain
bowel obstruction
perforation
perironitis

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10
Q

what are symptoms of spinal TB?

A

Pain
deformity
paraplegia

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11
Q

what are signs of pericardial TB?

A

tamponade

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12
Q

what are symptoms of renal TB?

A

renal failure

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13
Q

What are some 20th century TB tests?

A

ZN stain, AAFB

auramine

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14
Q

What test can show if a person has an inactive and active TB?

A

PCR

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15
Q

Why is PCR useful for diagnosing TB?

A

Can tell if it’s resistant to drugs- rifampracin

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16
Q

What is the histology of TB like?

A

Multinucleate giant cell granulomas
caseating necrosis
visible mycobacteria

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17
Q

what are key characteristics of TB in radiology?

A 
Upper lobe predominance
cavity formation
tissue destruction
scarring and shrinkage
heals with calcification
18
Q

what is miliary TB?

A

when myobacteria gets into the bloodstream?

also worry about renal cancer

19
Q

How do you treat TB?

A

Two months of: Rifampicin, Isoniazid, Pyrazinamide, Ethambutol

Then four months of: Rifampicin, Isoniazid

20
Q

Who can a person TB affect?

A

Everyone around them!!

21
Q

what are side effects of rifampicin?

A

Colours urine

Has many interactions with other drugs- eg. some contraceptive pills

22
Q

What are side effects of Ethambutol?

A

Can cause optic neuritis

23
Q

What are side effects of Isoniazid?

A

B-6 neuropathy

24
Q

When would you expect to see a sudden fall in actively replicating bacilli?

A

2 weeks after treatment

25
Q

What are types of TB drug resistance?

A

Single agent- Isoniazid
MDR- Rifmapicin & Isoniazid
XDR- MDR and quinolone and injectable

26
Q

If a person had HIV and TB which would you likely treat first?

A

HIV

27
Q

What is latent TB?

A

symptom free
culture negative
Balance between your organism and your immune system
(between a quarter and third of worlds population have this)

28
Q

What is IGRA test?

A

blood test, dectecys previous exposure to TB

29
Q

What is Mantoux test?

A

skin test, detecects previous exposure to TB and BCG

30
Q

Which test would be used for mass contact tracing?

A

IGRA

31
Q

how do you manage latent TB?

A

Treat or leave alone
anti-TNF drugs:
6 months isoniazid or 3 months rifampicin and isoniazid

32
Q

What increases risk of latent TB reactivation?

A

rheumatoid arthritis
TNFi
steroids/ immunosuppressant drugs

33
Q

How to stop spread of TB?

A 
Contact tracing
screening of high risk groups
isolation of infectious causes
BCG immunisation
social measures
34
Q

What test should all TB patients be offered?

A

HIV

35
Q

What should all patients with HIV be offered?

A

Chest X-ray

36
Q

What does ‘smear positive’ indicate?

A

active TB

37
Q

what is a d-shape on CXR associated with?

A

empyema

38
Q

who is at risk of pleural infection?

A 
Diabetes
immunosuppression
gastro-oesophageal reflux
alcohol missuse
IV drug abuse
39
Q

what are different types of pleural infection?

A

Simple parapneumponic effusion
complicated parapneumonic effusion
empyema

40
Q

what Pleural infection is pussy?

A

Empyema

41
Q

How do you manage pleural infection?

A 
Antibiotics
Drain effusion as needed
early discussion with surgeons if persistent sepsis
nutrition (albumin levels)
VTE prophylaxis
42
Q

which antibiotic is good for reaching the pleural space?

A

Vancamicin

Respiratory (19 decks)

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