Tuberculosis Flashcards

1
Q

what is tuberculosis

A

chronic granulomatous disease

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2
Q

what is the causative agent of tuberculosis

A

Mycobacterium tuberculosis

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3
Q

how is TB transmitted

A

inhalation of droplets containing Mycobacterium tuberculosis. via coughs

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4
Q

how does tuberculosis survive

A

after being phagocytosed by macrophages

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5
Q

which group of people are at greatest risk of TB

A

asian immigrants in the uK

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6
Q

what is primary TB

A

initial infection may be pulmonary or GI

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7
Q

what is miliary TB

A

results from haematogenous dissemination of TB

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8
Q

what is post-primary TB

A

caused by reinfection or reactivation

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9
Q

presentation of primary TB

A

fever, malaise, cough, wheeze, erythema nodosum, conjunctivitis

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10
Q

presentation of miliary TB

A

fever, weight loss, meningitis, yellow caseous tubercles spread to other organs

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11
Q

presentation of post-primary TB

A
Fever/night sweats  
Malaise  
Weight loss  
Breathlessness  
Cough  
Sputum  
Haemoptysis  
Pleuritic chest pain  
Signs of pleural effusion  
Collapse  
Consolidation  
Fibrosis
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12
Q

complications of pulmonary tuberculosis

A

bronchiectasis, pneumonia and pleural effusions

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13
Q

CNS presentation of TB

A

meningitis, headache, meningism, focal neurological signs, decreased consciousness

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14
Q

genitourinary presentation of TB

A

pyuria (sterile)

absceses

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15
Q

MSK presentation of TB

A

arthritis, osteomyelitis

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16
Q

GI presentation of TB

A

abdominal pain, obstruction, appendicitis

17
Q

what may happen to the lymph nodes in TB

A

they will be palpable, tender, firm superficial lymphadenopathy

18
Q

what skin (cutaneous) presentations may there be with TB

A

erythema nodosum

19
Q

investigations to do for Tuberculosis

A

Chest X-ray

Sputum samples for culture and sensitivity testing

Samples from non-pulmonary sites: may need biopsy and needle aspiration

PCR - GeneXpert, rapid results with additional drug sensitivity tested as well.

Mantoux test - usually offered to contacts of infected patients. Positive in those who have had the BCG vaccine.

20
Q

findings on a CXR of primary TB

A

peripheral consolidation

hilar lymphadenopathy

21
Q

findings on a CXR of miliary TB

A

fine shadowing

22
Q

findings on a CXR of post-primary TB

A

upper lobe shadowing

streaky fibrosis

calcification

pleural effusion

hilar lymphadenopathy

23
Q

1st line management of TB

A

Isoniazid, rifampicin, ethambutol, and pyrazinamide for 2 months, then Isoniazid and rifampicin for a further 4 months.

24
Q

2nd line management of TB

A

amikacin, macrolides, quinolones, and capreomycin