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respiratory > Tuberculosis > Flashcards

Tuberculosis Flashcards

1
Q

what is tuberculosis?

A

chronic granulomatous disease caused by mycobacterium tuberculosis

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2
Q

what is psoas sign?

A

pain when patient lies on their left side while the right thigh is flexed backwards

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3
Q

what does psoas sign indicate?

A

possible psoas abscess

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4
Q

what is the standard management regimen for TB?

A
  1. isoniazid + rifampicin + ethambutol + pyrazinamide for 2 months
  2. isoniazid + rifampicin for 6 months

duration extended if cerebral involvement or pericarditis

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5
Q

what are the side-effects of isoniazid?

A
  • peripheral neuropathy
  • liver toxicity
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6
Q

what medication is given to prevent peripheral neuropathy secondary to isoniazid?

A

pyridoxine (vitamin B6)

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7
Q

what are the side-effects of rifampicin?

A
  • liver toxicity
  • hepatic enzyme (p450) inducer
  • turns bodily fluids red/orange colour
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8
Q

what are the side-effects of ethambutol?

A
  • visual disturbance
  • avoid in chronic kidney disease
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9
Q

what are the side-effects of pyrazinamide?

A

liver toxicity

most hepatotoxic of all TB medications

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10
Q

what diagnosis should be investigated in all cases of TB?

A

HIV

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11
Q

what is a mantoux test?

A

tuberculin skin test

postive >/= 5mm induration

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12
Q

what is given the mantoux test?

A

contacts of TB

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13
Q

when in mantoux test positive?

A
  • active TB
  • previous BCG vaccination
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14
Q

who should receive the BCG vaccination?

A

tuberculin skin test negative (mantoux negative) contact of TB who is either:
* <35 years old
* >35 years old and work in healthcare

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15
Q

what TB medication is most likely to cause hepatotoxicity?

A

pyrazinamide

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16
Q

how is TB transmitted?

A

inhalation droplets infected with mycobacterium tuberculosis

17
Q

what are the clinical features of TB?

A
  • night sweats
  • fever
  • weight loss
  • other systemic symptoms
18
Q

what are the risk factors for TB?

A
  • ethnic minority groups
  • homelessness
  • drug and alcohol abuse
  • close contact with infected patient
  • immunosuppression
  • young or old age
19
Q

where is TB typically seen in the lungs?

A

apex

20
Q

what investigations are undertaken in suspected TB?

A
  • chest x-ray
  • sputum samples for culture and sensitivity testing
  • samples from non-pulmonary sites
  • samples are stained with Ziehl-Heelsen or auramine staining
  • for culture - Lowenstein-Jensen (LJ) media is needed
  • PCR
  • interferon-gamma release assays (IGRAs)
  • mantoux test
21
Q

what are the typical findings on chest x-ray in TB?

A

cavitating lesion in the apex

22
Q

what is pott’s disease?

tubercular spondylitis

A
  • localised back pain
  • neurological deficits
  • radiographic findings indicative of vertebral body involvement
  • biopsy demonstrating granuloma formation

respiratory (10 decks)

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