Tuberculosis

Question 1

what may be heard on auscultation?

Answer 1

crackles,
bronchial breath sounds,
or amphoric breath sounds (distant hollow breath sounds

Question 2

ivx and findings?

Answer 2

Sputum sample;

• 3 sputum samples collected for acid-fast bacilli smear AND culture;
• NAAT test should be performed on at least one respiratory specimen.

CXRay;

• fibronodular opacities in upper lobes with or without cavitation.
• atypical disease; middle/lower lobe lesions
• hilar adenopathy

Bloods

OTHERS;

1. Interferon gamma release assays eg quantiferon
   - positive

• Bronchoalveolar lavage ->
o Auramine stain = screening
o Ziehl-Neelson / ZH stain = diagnosis

Question 3

tb drug regimen?

Answer 3

all 4 for 2 (RIPE)

then the first 2 for 4 more (RI)

Question 4

SIDE EFFECTS OF rifampicin?

Answer 4

Orange secretions, raised ALT/AST, inducer

Question 5

SIDE EFFECTS OF Isoniazid?

Answer 5

DILI, peripheral neuropathy (give w/ pyridoxine), inhibitor

Question 6

SIDE EFFECTS OF ethambutol?

Answer 6

Visual disturbance

Question 7

Multi-Drug Resistant / MDR TB cant have which drugs?

Answer 7

 rifampicin and isoniazid

Question 8

how is PCP ivx?

Answer 8

 CXR (bilateral interstitial pulmonary infiltrates – but can be normal)
 Exercise-induced desaturation
 BAL > sputum ( then silver stain shows characteristic cysts - pneumatoceles)

Question 9

mx of PCP?

Answer 9

Mild- mod: Co-trimoxazole
- trimethoprim and sulfamethoxazole

Severe: IV pentamidine

Question 10

complications of TB?

prognosis?

Answer 10

Empyema

Brnochiectasis

Pneumothorax

ARDS

Without treatment the mortality rate of TB exceeds 50%. however they do well with rx