Tuberculosis Flashcards
Definition of tuberculosis
Granulomatous disease caused by mycobacterium tuberculosis
Transmission of TB
Transmitted by inhalation of droplets
What is primary TB
90% - immune system localised infection to hilar lymph nodes and are eliminated or encapsulated by barrier of granulation tissue
What is secondary TB
Progression to active TB in those immunocompromised.
What part of the lung is TB commonly found
In the apex of the lung
What is miliary TB
Primary infection not contained and disseminates via bloodstream
Risk factors for TB
Ethnic minority groups, homeless, drug/alcohol abuse, close contact, immunosuppression, young or old age
General presentation of patient with TB
Subacute - chronic onset which depends on main site of infection - includes night sweats, fever, weight loss, systemic symptoms
What are the pulmonary features of TB
Chronic cough, productive of purulent sputum with or without haemoptysis. Can have bronchiectasis, pneumonia and pleural effusion
Most common presenting features of TB
Pulmonary symptoms
What are the CNS features of TB
TB meningitis or tuberculoma, headache, meningism, focal neurological signs and decreased consciousness
Which is the second most affected organ in TB
Genitourinary system
What are the genitourinary features of TB
Sterile pyuria, kidney pathology, abscesses, salpingitis, infertility and epididymo-orchitis
What are the MSK feature of TB
Arthritis, osteomyelitis, psoas abscess, Potts disease of spine
What are the GI features of TB
Abdominal pain, obstruction due to ileocaecal lesions, can spread to peritoneum
What are the cardiac features of TB
Pericardial effusions, constrictive pericarditis
What are the cutaneous features of TB
Wide range of skin reactions - erythema nodusum, Bazin’s disease
Samples and culturing in TB
Samples of sputum for culture and sensitivity testing. Stained with Ziehl-Neelsen or Auramine for microscopy
Investigations into TB
CXR, PCR, IGRA, to test if latent or active TB, mantoux test for contacts
First round of medical treatment of TB
Isoniazid, Rifampicin, Ethambutol and Pyrazinamide
Second round of medical treatment of TB
Isoniazid and Rifampicin
How long of treatment for first round of medication
2 months
How long of treatment for second round of medication
4 months
When is medication required for longer
Meningitis, pericarditis and spinal TB
