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RESP FLASHCARDS > tuberculosis > Flashcards

tuberculosis Flashcards

1
Q

what is tuberculosis

A

a granulomatous caseating disease caused by mycobacteria

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2
Q

describe mycobacteria

A
  • aerobic
  • non-motile
  • non-sporing
  • slow growing bacilli
  • thick waxy capsule
  • Resistant to phagolysosomal killing and able to remain dormant
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3
Q

what is mycobacterium tuberculosis complex

A

4 species of mycobacteria that are TB causing
1. M tuberculosis
2. M africarium
3. M microtis
4. M bovis

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4
Q

where is TB very common

A

africa and south asia

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5
Q

how does TB spread

A

spread via respiratory droplets as it is an airborne infection

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6
Q

risk factors for TB

A
  • travel to associated country
  • immunocompromised eg HIV
  • homeless/crowded housing
  • IVDU
  • smoking+alcohol
  • increasing age
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7
Q

pathophysiology of TB

A
  1. Alveolar macrophages ingest the bacteria, but the bacteria resist being killed so a granuloma forms.
  2. T-cells are recruited and surround the granuloma. The central part of the granuloma undergoes necrosis and has a cheese-like appearance = caseating granuloma which is referred to as a primary ghon focus.
  3. The ghon focus spreads to nearby lymph nodes. Ghon focus + lymph node spread = ghon complex.
    If TB spreads systemically it is referred to as miliary TB.
  4. Most often it is contained within the granuloma but stays alive so known as latent TB.
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8
Q

does latent TB have symptoms

A

no it is asymptomatic

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9
Q

systemic symptoms of TB

A
  • Weight loss
  • Low grade fever
  • Anorexia
  • Drenching night sweats
  • Malaise
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10
Q

pulmonary symptoms of TB

A
  • Productive cough
  • Haemoptysis
  • Cough >3 weeks (dry or productive
  • Breathlessness
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11
Q

extrapulmonary symptoms of TB

A
  • meningitis
  • skin changes
  • TB pericarditis
  • joint pain
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12
Q

signs of TB

A
  • Dullness to percussion
  • Decreased breathing
  • Fever
  • Crackles
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13
Q

3 main investigations for TB

A
  1. chest x ray
  2. sputum culture
  3. biopsy
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14
Q

what is the sputum culture to diagnose TB

A

sputum culture for acid-fast bacilli:

– Ziehl-Neelsen stain -> turns red/pink

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15
Q

how to diagnose latent TB

A
  • Tuberculin skin test ‘Mantoux’
  • Interferon gamma release assay
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16
Q

treatment of TB

A

RIPE
1. rifampacin
2. isoniazid
3. pyrazinamide
4. ethambutol

17
Q

how long is rifampacin given for TB and what are the side effects

A

approx 6 months

red/bloody urine (haematuria)

18
Q

how long is isoniazid given for TB and what are the side effects

A

approx 6 months

peripheral neuropathy

19
Q

how long is pyrazinamde given for TB and what are the side effects

A

approx 2 months

hepaptits, gout

20
Q

how long is ethambutol given for TB and what are the side effects

A

approx 2 months

eye problems - optic neuritis

RESP FLASHCARDS (20 decks)

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