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exam - M - Respiratory diseases (Megan) > Tuberculosis > Flashcards

Tuberculosis Flashcards

1
Q

what organism causes tuberculosis?

A

Mycobacterium tuberculosis bacteria.

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2
Q

what is the shape of the bacteria causing tuberculosis?

A

mycobacterium tuberculosa - rod shaped (bacilli).

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3
Q

what do the tuberculosis bacteria do on staining?

A

They don’t take up normal stain. this is called ‘acid-fast bacilli’.

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4
Q

what staining is used for tuberculosis?

A

Ziehl-neelsen stain.

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4
Q

what staining is used for tuberculosis?

A

Ziehl-neelsen stain.

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5
Q

what do the tb bacteria stain on ziehl Neelsen staining?

A

stain red on a blue background.

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6
Q

what is a typical story of a patient with TB?

A

patient coughs up sputum.
contains acid fast bacilli that strains red.
= Tuberculosis.

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7
Q

what are the risk factors of TB?

A 
Healthcare worker, 
close contact with TB - place or person
alcohol abuse
drug abuse 
homeless
born in a country with high TB rates 
immunocompromised (HIV)
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8
Q

how is TB spread?

A

By inhaling saliva droplets. it spreads through lymphatics and blood.

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9
Q

what is active TB?

A

when the disease is active in the person.

Usually forms granulomas throughout the body.

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10
Q

what is latent TB?

A

When the immune system has formed capsules around the infection, so the person doesn’t have active infection but the bacteria is still there and might be reactivated.

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11
Q

what is secondary TB?

A

When latent TB is reactivated.

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12
Q

what is military TB?

A

when the immune system can’t control the TB leading to disseminated severe disease.

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13
Q

what’s the most common type of TB?

A

Pulmonary TB - due to the bacterias high oxygen demand.

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14
Q

where is common sites for extra pulmonary TB?

A 
lymphatics (abscess in the neck) 
GI
pleura 
pericardium
CNS
bones 
joints
cutaneous
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15
Q

what type of vaccine is the BGC?

A

Live attenuated - weakened form of the bacteria

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16
Q

what does the BCG vaccine prevent against?

A

Good at - preventing severe disease.

less good at - preventing pulmonary disease.

17
Q

where is the BCG given?

A

intradermal (between epidermis and dermis).

ONLY VACCINE TO BE GIVEN INTRADERMALLY.

18
Q

Who should not be given the vaccine?

A

Immunocompromised.

19
Q

what test is used to check for previous TB infection/vaccination?

A

Manteaux test.

20
Q

what shows a positive manteau test?

A

test is read after 72hrs.

>5mm or =5mm.

21
Q

what is done if the manteau test is positive?

A

patient is tested for active disease.

Chest X-ray + cultures.

22
Q

where is the manteaux test injected into?

A

Intradermal, causes a bleb.

23
Q

what type of cultures are done when investigating TB?

A

blood culture.
sputum culture.
aspiration of lymph node culture.

24
Q

who is offered the BCG vaccine?

A

High risk:

  • healthcare workers
  • neonates born in high risk area of UK
  • neonates with family history of TB
  • neonates with family members from high risk countries
  • unvaccinated people <35yrs who have close contact who is positive
  • children and young adults who have recently come from a country at high risk
25
Q

how much TB does pulmonary TB account for?

A

70%

26
Q

What are the signs and symptoms of pulmonary TB?

A 
GRADUALLY WORSENING.
night sweats
lymphadenopathy 
erythema nodosum (red sore lesions on shins)
lethargy 
fever
weight loss
cough - which brings up sputum
haemoptysis
27
Q

what is TB of the spine called?

A

Pott’s disease.

28
Q

what does the manteaux test show?

A
  • previous TB infection
  • previous BCG vaccine
  • active TB
  • latent TB
29
Q

what is done to confirm latent TB after manteaux test if the tests for active TB are negative?

A

interferon gamma release assays - whole blood test.

30
Q

what must be done before someone gets BCG vaccine?

A

Manteaux test - which must be negative.

31
Q

how many culture samples should be taken?

A

3.

32
Q

when should TB treatment be started?

A

As soon as possible, when waiting on culture results because thy take a long time.

33
Q

is latent TB treated?

A

Not always, only if the person is at risk of reactivation.

34
Q

what is the treatment for latent TB?

A
  • isoniazid + rifampicin = 3 months

OR

  • isoniazid alone = 6 months.
35
Q

What is the treatment for active TB?

A
  • Rifampicin - 6 months
  • Isoniazid - 6 months
  • pyrazinamide - 2 months
  • ethambutol - 2 months.
36
Q

what are the side effects of the drugs used to treat TB?

A
  • rifampicin - red pee/tears
  • isoniazid - peripheral neuropathy
  • pyrazinamide - hyperuricaemia (gout)
  • ethambutol - colour blindness
37
Q

which drugs have a risk of hepatotoxicity?

A

rifampicin
isoniazid
pyrazinamide

38
Q

what should be prescribed with RIPE drugs?

A

pyridoxine - Vitamin B6 - to reduce peripheral neuropathy.

39
Q

what drug does rifampicin reduce effectiveness of?

A

Oral contraceptive pill.

40
Q

what does military TB look like on chest X-ray?

A

Millet seeds.

41
Q

when is TB considered non-contagious?

A

After 2 weeks of medication.

exam - M - Respiratory diseases (Megan) (24 decks)

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