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Respiratory > Tuberculosis > Flashcards

Tuberculosis Flashcards

1
Q

What is the Greek name for Tuberculosis?

A

Pthisis

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2
Q

What is the Old English name for Tuberculosis?

A

Consumption

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3
Q

What is the Latin name for Tuberculosis?

A

Scrofula

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4
Q

What is the Sanskrit name for Tuberculosis?

A

Yaksma

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5
Q

What are the most common species that can cause tuberculosis?

A

Mycobacterium tuberculosis
Mycobacterium africanum
Mycobacterium bovis

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6
Q

Which Mycobacterium species is responsible for leprosy?

A

Mycobacterium leprae

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7
Q

What are the characteristics of Mycobacterium tuberculosis?

A

They are strict aerobic, rod shaped, gram positive bacilli, with acid fast characteristics, meaning that they are not decolourised by acid staining due to their waxy coating

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8
Q

How is M.tuberculosis spread?

A

They are small ad so are easily spread by fluid droplets

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9
Q

What are the 3 pathways that can occur after exposure to TB pathogens?

A

It can cause no infection and the pathogen is removed
It can cause a latent infection that does not presently cause symptoms
It can cause an active infection that will cause symptoms

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10
Q

What percentage of latent TB infections will become active later on?

A

5-10%

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11
Q

How does TB become latent?

A

Mycobacteria are engulfed by phagocytes and are presented on MHCs
This activates CD4+ T cells
This can take up to 8 weeks, meanwhile the bacteria can grow
CD4+ T cells release interferon gamma
This cause latent infection (Or death or spread)
This allows formation of a granuloma, in which CD4+ T cells surround the infected phagocytes and an immune response is launched, forming a calcified mass to form

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12
Q

Who is most at risk of TB?

A

Those with a recent exposure to someone with a smear positive case
Those who are socially deprived
Those who are immunosuppressed
Those travelling from South Asia or Southern Africa

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13
Q

What are some common symptoms of tuberculosis?

A

Night sweats
Fever
Loss of appetite
Weakness
Fatigue
Weight loss
Persistant, productive cough, lasting over 3 weeks and causing haemoptysis

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14
Q

What is meant by miliary TB?

A

TB that spreads in the blood and causes deposition of TB bacteria in the lungs, giving a millet seed appearance on examination

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15
Q

What are some examples of microbiological diagnosis techniques for TB?

A

3 sputum cultures
Gastric washings in children
Biopsies
Microscopy
Ziehl-Neelsen staining (Acid fast)
Auramine staining (Acid fast)

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16
Q

Describe the histology of latent TB?

A

A granuloma with central caseous necrosis
Ghon focus

17
Q

How are skin tests used in TB diagnosis?

A

An inactivated form of TB is injected under the skin
If the skin becomes inflamed, it shows either active or latent TB as it shows a primed immune system to TB antigens

18
Q

What are some other tests available for TB?

A

ELISA tests
ELISpot testing
PCR testing

19
Q

What is the drug regimen for active TB?

A

4 drugs for 2 months and then 2 drugs for a further 4 months
4 drugs (RIPE):
- Rifampicin
- Isoniazid
- Pyrazinamide
- Ethambutol
2 drugs:
- Rifampicin
- Isoniazid

20
Q

What are some side effects of Rifampicin?

A

Can suppress the bone marrow, increasing the risk of infection
Causes red/orange urine discolouration (Rifampicin = Red pissing)

21
Q

What is a major side effect of Isoniazid?

A

Peripheral neuropathy (Numbness in extremities)

22
Q

What is a major side effect of Pyrazinamide?

A

It can cause hyperuricaemia (High uric acid) and thus cause gout, which affects the joints

23
Q

What are some major side effects of Ethambutol?

A

It can effect sight and cause colour vision disturbances

24
Q

What is the drug regiment for latent tuberculosis?

A

Either 2 drugs for 3 months or 1 drug for 6 months
The 2 drugs:
- Rifampicin
- Isoniazid
The 1 drug:
- Isoniazid

25
Q

Why might a patient opt not to take Rifampicin in the treatment of latent TB?

A

It cannot be taken with the oral contraceptive, so younger women may not wish to take it, and instead will take Isoniazid only for 6 months

26
Q

How can TB infection can be prevented?

A

There are vaccination regimes such as the BCG vaccine which can be given to babies, children and adults who are at risk of TB

27
Q

What are some risk factors for tuberculosis?

A

silicosis
chronic renal failure
HIV positive
solid organ transplantation with immunosuppression
intravenous drug use
haematological malignancy
anti-TNF treatment
previous gastrectomy

28
Q

How does isoniazid work?

A

It inhibits myconic acid synthesis

Respiratory (23 decks)

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