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Year 1- Respiratory > Tuberculosis > Flashcards

Tuberculosis Flashcards

1
Q

Describe the groups vulnerable to getting TB in the UK.

A

-HIV positive individuals
-Immunosuppressed individuals
-People from high prevalence countries
-Elderly, neonates, diabetics
-Homeless
-Alcoholics
-Prison

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2
Q

What proportional of all TB cases in the UK are alcoholics/homeless/in prison?

A

1 in 10

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3
Q

TB kills more than which two diseases together?

A

Malaria and HIV

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4
Q

What ranking is TB on deaths of commuincable diseases?

A

2
after Covid-19

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5
Q

How many people worldwide are estimated to have TB?

A

2 billion

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6
Q

List some countries where TB is more prevalent.

A

Nigeria, Pakistan, China, Philippines, Bangladesh, India, Indonesia

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7
Q

Where are mycobacteria found?

A

Soil and water

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8
Q

Name some species of mycobacteria responsible for TB.

A

M. tuberculosis, M.africanum, M. bovis

M= mycobacteria

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9
Q

What mycobacteria causes leprosy?

A

M.leprae

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10
Q

Describe mycobacteria.

A

Non-motile bacillus, very slowly growing, aerobic

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11
Q

What can be frustrating about diagnosing/treating TB?

A

Disease is slow and long to treat

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12
Q

Which part of the lungs does TB affect?

A

Upper part of the lungs- aerobic

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13
Q

Describe the cell wall of mycobacteria.

A

Thick and fatty cell wall

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14
Q

Due to the thick and fatty cell wall, what are mycobacteria resistant to?

A

Acids, alkalis, detergents
Neutrophil and macrophage detruction

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15
Q

What is the route of transmission for TB?

A

Airbourne

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16
Q

What is the one exception to the transmission of TB being airborne?

A

thanksjacquelinewilsonforwritingqueenie

Cows milk- unpasteurised and infected by Mycobacterium bovi

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17
Q

List some ways TB is NOT spread.

A
  • Shaking hands
  • Sharing food
  • Touching surfaces
  • Sharing toothbrushes
  • Kissing
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18
Q

How can someone get TB via the air?

A

TB bacteria attached to aerosol droplets which can remain suspended in air for many
hours, especially if there is poor air circulation
Someone else breathes these bacteria in

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19
Q

What is usually required for someone to develop TB?

A

Prolonged contact

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20
Q

How is mycobacteria eliminated outdoors?

A

UV radiation and dilution

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21
Q

What % of all TB cases are in the lungs?

A

50%

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22
Q

What is the second most likely part of the body to get infected by TB after the lungs?

A

Lymph nodes

23
Q

Does post-primary TB occur in humans or animals?

A

Only in humans

24
Q

What is DOT?D

A

Directly observed therapy

Nurse goes into the home of individual infected w TB to watch them take their medication to reduce likelihood of spreading it to others.
Often happens with people who may struggle to remember to take medication.

25
What happens to TB bacteria in alveoli?
Macrophages recognize it and ingest the bacteria T helper cells are activated and come from the lymph nodes. Lymph nodes secrete various cytokines Macrophages become activated
26
What do activated macrophages turn into?
Langhan's giant cells
27
What forms when there is an accumulation of Langhan's giant cells, macrophages and epithelioid?
Granuloma
28
What can the granuloma lead to?
Necrotic tissue, which may calcify later and tissue damage
29
Why are there pros and cons to Th1 cell mediated immunological responses?
Eliminates / Reduces number of invading mycobacteria Tissue destruction is a consequence of activation of macrophages
30
What does the outcome of a TB infection depend on?
Infection and Susceptibility
31
What is meant by infection in terms of the outcome?
Virulence of infection Number of infections
32
What is meant by susceptibility in terms of the outcome?
Genetics Nutrition Age Immunosuppression
33
What are the three paths that a primary infection of TB could go down?
Progressive disease Contained/ latent Cleared/cured
34
What can primary infection lead to?
Tuberculous bronchopneumonia Miliary TB
35
What is Bronchopneumonia?
Bronchopneumonia is a type of pneumonia that causes inflammation in the alveoli.
36
What can happen in Tuberculous bronchopneumonia?
Enlargement of hilar lymph compresses bronchi which can lead to lobar collapse. Enlargement of lymph node can discharge into the bronchus
37
What happens in miliary TB?
Hematogenous spread of bacteria to multiple organs Looks like millet seeds on autopsy
38
What are the two hypotheses for why humans develop post-primary TB while animals do not?
1. TB bacteria entering a dormant stage with low or no replication over prolonged periods of time 2. Balanced state of replication and destruction by immune mechanisms
39
How long can Miliary, Meningeal, Pleural TB last?
6-12 months
40
How long can post primary TB last?
1-5 years But could be 30-40
41
How long can Genitourinary, Cutaneous TB last?
10-15 years But could be 30-40
42
What is the clinical presentation for someone w TB?
* Cough * Fever * Sweats (mainly at night) * Weight loss
43
What is important to note about the presenting symptoms?
A lot of people don't have all of them and some don't have any.
44
What may a chest xray look like in someone w TB?
Apices, soft ‘fluffy/nodular upper zone- like cotton wool Cavitation in 10-30%
45
When might you consider CT for a patient with suspected/confirmed TB?
*Normal CXR but clinical suspicion * Miliary TB * Cavitation & other differential * Lymphadenopathy, alternative diagnosis * targets for BAL
46
Are mediastinal lymphadenopathy usually bilateral or unilater?
Unilateral
47
List some of the investigations used to diagnose TB
* Sputum; 3 samples, 8-24hrs gap, at least 1 early morning sample * Induced sputum * Bronchoscopy with BAL * Endobronchial ultrasound (EBUS) with biopsy * Lumbar puncture in CNS TB * Urine in urogenital TB * Aspirate/biopsy from tissue ( lymph-node, bone, joint, brain, abscess …)
48
Multi drug treatment is used when treating TB. Why?
Single agent treatment leads to drug resistant organisms within 14 days
49
In terms of treatment for TB, how can you remember number and types of treatment?
4/2:2/4
50
Describe 4/2:2/4
Four drugs for two months Two drugs for four months
51
Which two drugs do you have for the whole six months of treatment?
Rifampicin and isoniazid,
52
Which two drugs do you add in, alongside Rifampicin and isoniazid,, for the first two months of treatment?
Pyrazinamide and ethambutol
53
What can be given to reduce risks of isoniazid induced poly neuropathies?
Vitamin B6
54
Which vaccine is given to selected groups to help reduce risks of TB?
BCG vaccine

Year 1- Respiratory (36 decks)

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