Tuberculosis

Question 1

What is the characteristic size range of Mycobacterium tuberculosis?

Answer 1

0.2 to 0.6 x 2-4 micrometers.

Question 2

Which component of the cell wall contributes to the acid-fastness of Mycobacterium tuberculosis?

Answer 2

Mycolic acid.

Question 3

What is the primary mode of transmission of tuberculosis?

Answer 3

Inhalation of droplet nuclei.

Question 4

How long can the infectious particles of tuberculosis remain suspended in the air?

Answer 4

Up to 30 minutes.

Question 5

Which countries accounted for two-thirds of the global total of tuberculosis cases in 2022?

Answer 5

India, Indonesia, China, the Philippines, Pakistan, Nigeria, Bangladesh, and the Democratic Republic of the Congo.

Question 6

What are the risk factors associated with tuberculosis?

Answer 6

Poverty, overcrowding, malnutrition, immunosuppression, migration/travel, drug-resistant TB, chronic diseases, cohabitation with active cases, healthcare workers, drug/alcohol abuse.

Question 7

Which virulence factor of Mycobacterium tuberculosis inhibits the migration of leukocytes and causes chronic granulomas?

Answer 7

Cord factor (trehalose-6,6’-dimycolate).

Question 8

What type of hypersensitivity can polysaccharides induce in tuberculosis?

Answer 8

Immediate type of hypersensitivity.

Question 9

How does tuberculosis primarily spread beyond the pulmonary system?

Answer 9

Direct, hematogenous, lymphatic, swallowing of sputum.

Question 10

What is the characteristic lesion formed in the lungs during primary tuberculosis?

Answer 10

Tubercle.

Question 11

What is the primary mode of transmission of tuberculosis?

Answer 11

Inhalation of droplet nuclei.

Question 12

What is the role of cytokines and lymphokines in the pathogenesis of tuberculosis?

Answer 12

They stimulate monocytes and macrophages.

Question 13

What happens to the tubercle bacilli within the alveolar macrophages?

Answer 13

Replicate within for 2-3 weeks.

Question 14

What is the consequence of the erosion of granuloma and surrounding tissue in tuberculosis?

Answer 14

Spread through air passages to other parts of the lung.

Question 15

How does active tuberculosis spread through the lymphatic system?

Answer 15

Through lymphatic vessels.

Question 16

What is the primary manifestation of primary tuberculosis?

Answer 16

Primary complex with lesion and draining gland.

Question 17

How does tuberculosis present radiographically in the lungs during primary tuberculosis?

Answer 17

Hilar adenopathy, mid and lower lung field pulmonary infiltrates.

Question 18

What are the common clinical symptoms of reactivation tuberculosis?

Answer 18

Fever, cough, weight loss, night sweats.

Question 19

What are the typical radiographic findings in reactivation tuberculosis?

Answer 19

Apical-posterior lung infiltrates, cavities, nodules, effusions, hilar adenopathy.

Question 20

What percentage of active pulmonary tuberculosis cases have normal chest X-rays?

Answer 20

5%.

Question 21

What percentage of tuberculosis cases present as extrapulmonary tuberculosis?

Answer 21

15%.

Question 22

Which organ system is most commonly affected in extrapulmonary tuberculosis?

Answer 22

CNS.

Question 23

What are the common presentations of tuberculous lymphadenitis?

Answer 23

Chronic, unilateral non-tender lymphadenopathy, especially cervical lymph nodes.

Question 24

What are the clinical features of tuberculous meningitis?

Answer 24

Malaise, headache, low-grade fever.

Question 25

What is the prodromal phase of tuberculous meningitis characterized by?

Answer 25

Fever, nuchal rigidity, altered mental status.

Question 26

What neurological symptoms can occur due to CNS tuberculoma?

Answer 26

Focal neurological symptoms.

Question 27

What are the features of tuberculous pericarditis?

Answer 27

Features of pericardial effusion or constrictive pericarditis.

Question 28

What is the most common site of skeletal tuberculosis?

Answer 28

Thoracolumbar spine.

Question 29

What is the acute, severe form of tuberculosis caused by hematogenous spread?

Answer 29

Miliary tuberculosis.

Question 30

How is latent tuberculosis infection diagnosed?

Answer 30

Positive result on Tuberculin Skin Test (TST) or Interferon-gamma release assay (IGRA).

Question 31

What diagnostic methods are used to establish active tuberculosis?

Answer 31

Combination of epidemiological, clinical, radiographic, microbiological, and histopathologic criteria.

Question 32

Which clinical specimen is used for diagnosing pulmonary tuberculosis?

Answer 32

Spontaneously expectorated sputum.

Question 33

What type of media is used for culturing Mycobacterium tuberculosis?

Answer 33

Egg-based, agar-based, or liquid-based media.

Question 34

What are the first-line drugs used in the treatment of tuberculosis?

Answer 34

Isoniazid, Rifampicin, Ethambutol, Pyrazinamide.

Question 35

Name two second-line drugs used in tuberculosis treatment.

Answer 35

Fluoroquinolones, Thioamides.

Question 36

What complication of tuberculosis can result in sudden death due to arterial wall erosion?

Answer 36

Massive hemoptysis.

Question 37

What is the primary preventive measure for tuberculosis?

Answer 37

Early diagnosis, universal drug-susceptibility testing, systematic screening, treatment of all TB cases.

Question 38

Besides early diagnosis and treatment, what other preventive measures are recommended for tuberculosis control?

Answer 38

Collaborative TB/HIV activities, management of comorbidities, preventive treatment, vaccination, cough hygiene, airborne transmission precautions.

Question 39

What precautions should be taken in healthcare facilities to prevent the transmission of tuberculosis?

Answer 39

Cough hygiene, airborne transmission precautions.

Question 40

What are the social determinants of tuberculosis that should be addressed for prevention and control?

Answer 40

Improved nutrition, housing, social protection, poverty alleviation.