Tuberculosis Flashcards
what is tuberculosis
chronic granulomatous disease
what is the causative agent of tuberculosis
Mycobacterium tuberculosis
how is TB transmitted
inhalation of droplets containing Mycobacterium tuberculosis. via coughs
how does tuberculosis survive
after being phagocytosed by macrophages
which group of people are at greatest risk of TB
asian immigrants in the uK
what is primary TB
initial infection may be pulmonary or GI
what is miliary TB
results from haematogenous dissemination of TB
what is post-primary TB
caused by reinfection or reactivation
presentation of primary TB
fever, malaise, cough, wheeze, erythema nodosum, conjunctivitis
presentation of miliary TB
fever, weight loss, meningitis, yellow caseous tubercles spread to other organs
presentation of post-primary TB
Fever/night sweats Malaise Weight loss Breathlessness Cough Sputum Haemoptysis Pleuritic chest pain Signs of pleural effusion Collapse Consolidation Fibrosis
complications of pulmonary tuberculosis
bronchiectasis, pneumonia and pleural effusions
CNS presentation of TB
meningitis, headache, meningism, focal neurological signs, decreased consciousness
genitourinary presentation of TB
pyuria (sterile)
absceses
MSK presentation of TB
arthritis, osteomyelitis
GI presentation of TB
abdominal pain, obstruction, appendicitis
what may happen to the lymph nodes in TB
they will be palpable, tender, firm superficial lymphadenopathy
what skin (cutaneous) presentations may there be with TB
erythema nodosum
investigations to do for Tuberculosis
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.
findings on a CXR of primary TB
peripheral consolidation
hilar lymphadenopathy
findings on a CXR of miliary TB
fine shadowing
findings on a CXR of post-primary TB
upper lobe shadowing
streaky fibrosis
calcification
pleural effusion
hilar lymphadenopathy
1st line management of TB
Isoniazid, rifampicin, ethambutol, and pyrazinamide for 2 months, then Isoniazid and rifampicin for a further 4 months.
2nd line management of TB
amikacin, macrolides, quinolones, and capreomycin
