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The Respiratory System > Tuberculosis > Flashcards

Tuberculosis Flashcards

1
Q

Tb is an _________ pathogen

A

Airborne

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2
Q

What is the difference between Tb infection and TB disease?

A

TB infection is a condition in which a person is infected with TB bacteria but does not have active disease or symptoms, while

TB disease is a serious condition in which the bacteria are multiplying and causing active infection in the body, with symptoms and contagiousness.

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3
Q

Where will Tb normally be more prevalent in the lungs?

A

Apices

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4
Q

Why does Tb usually grow preferentially in the lung apices?

A

Tb is an aerobic pathogen

In the apices of the lungs there is generally more ventilation than perfusion meaning inhaled aerobic pathogens will thrive most here

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5
Q

Which type of bacteria is Tb?

A

Bacilli

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6
Q

Why does Tb involve gramuloma formation?

A

Tb can enter alveoli and enter macrophages.

To respond, the body walls off the infected macrophages in a granuloma

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7
Q

In people experiencing Tb symptoms, the body cannot hold the ________ within the _________

A

Infection

Granuloma

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8
Q

How long can a granuloma hold the infection of Tb at bay?

A

It can vary from days to years

A Tb infection can remain “dormant” for many years

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9
Q

Systemic symptoms of Tb include?

A

Weight loss, Erythema nodosum and night sweats

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10
Q

Respiratory symptoms of Tb include?

A

Cough, haemoptysis, breathlessness and upper zone crackles

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11
Q

If lower lobes are infected with Tb, what does this suggest?

A

The infection occured through blood spread (sepsis)

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12
Q

Tb does not just infect the lungs. What are some other complications of Tb?
known as extrapulmonary TB

A
  • Meningeal Tb
  • GI Tb
  • Spinal Tb
  • Cold abscesses
  • Lymphadeopathy
  • Pericardial - cardiac tamponade
  • Renal
  • Septic arthritis
  • Adrenal - hypoadrenalism
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13
Q

Which type of stan can detect Tb?

A

Ziehl-Neelson

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14
Q

Describe the process by which Tb is identified through staining

A
  • Tb is stained
  • Alcohol and acid are added to remove the stain as far as possible
  • The sample is washed with blue stain
  • Any areas still red show presence of Tb which retains the original stain
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15
Q

Tb can be identified by staining, how else can it be identified?

A

PCR (polymerase chain reaction)

Culturing

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16
Q

The histology of Tb includes ___________ giant cell _________, _________ necrosis and potentially visible ___________

A

Multinucleate

Granulomas

Caseating

Mycobacteria

17
Q

What is the treatment for Tb?

A

6 month antibiotic course

  • 2 months of
  • Rifampicin
  • Isoniazid
  • Pyrazinamide
  • Ethambutol

Followed by

  • 4 months of
  • Rifampicin
  • Isoniazid
18
Q

What is a side effect of rifampicin?

A

It colours everything orange

(Bodily fluids, urine etc)

They noticed their urine or tears are orange or red: rifampicin (“red-an-orange-pissin’”).

19
Q

What is a side effect of ethambutol?

A

It can cause optic neuritis
They noticed difficulty recognising colours: ethambutol (“eye-thambutol”)

20
Q

Why does Tb treatent take so long?

A

There are two Tb populations:

  1. The replcating bacilli
  2. The trapped bacilli
21
Q

What are the different types of Tb resistance?

A
  • Single agent
  • Multi-drug resistance
  • Extensive drug resistance (rifampicin, isoniazid and quinolone plus an injectable)
22
Q

What is latent Tb disease?

A

Symptomless Tb - Tb is in a dormant state

23
Q

How can it be determined that Tb is active?

A
  • Symptoms present
  • Cues through history
  • X-rays (can show previous Tb by calcification)
  • Culturing is positive
24
Q

What are two tests for previous Tb exposure?

A
  1. Interferon gamma release
  2. Mantoux (tuberculin test)

Tuberculin is a protein taken from mycobacteria which can prvoke a hypersensitivity reaction so it involves two visits, one for administering the tuberculin, another for measuring the response

25
Q

What is an alternative test to the tubercuin test that is more sensitive?

A

IGRA

(Interferon Gamma Release Assay)

26
Q

Why would latent Tb be treated?

A

There is a chance the patient may eventually develop symptoms

6 months of rifampicin

or

3 months of rifampicin and isoniazid

27
Q

Tb often comes hand in hand with which other condition?

A

HIV

28
Q

What are some risk factors for pleural infection?

A
  • Diabetes
  • Immunosupression from corticosteroids
  • Gastro-oesophageal reflux
  • Alcoholism
  • IV drug user
29
Q

What is a parapneumonic effusion?

A

A type of pleural effusion that arises as a result of pneumonia, lung abcess or bronchiectasis

30
Q

What are the three types of parapneumonic effusion?

A
  1. Simple parapneumonic effusion
  2. Complicated parapneumonic effusion
  3. Empyema
31
Q

What is an empyema?

A

A collection of pus in the pleural space

32
Q

Large effusions will require _____ _________

A

Chest drainages

33
Q

What can be used to break down substances in parapneumonic effusions?

A

Fibrinolytics and DNAses

34
Q

What characteristics will a complicated effusion have?

A
  • Ph < 7.2
  • Low glucose
  • Septations (divided into segments)
  • Loculations (containing many cavities)
  • +ve on gram stain
35
Q

what medications should not be given to patients with latent TB

A

immunosuppression such as TNF alpha inhibitors

The Respiratory System (19 decks)

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