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Clinical lectures: Yr2 > Tuberculosis > Flashcards

Tuberculosis Flashcards

1
Q

What is Tuberculosis?

A

Mycobacterial infection caused by Mycobacteria tuberculosis complex/Koch’s bacillus that mostly affects the lungs

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2
Q

What is Latent Tuberculosis Infection (LTBI)?

A

Individual infected with M. tuberculosis complex but doesn’t have active TB and is not contagious

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3
Q

What is the leading global cause of death due to infection by a single pathogen?

A

Tuberculosis

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4
Q

In which groups is the highest incidence of TB found?

A

Ethnic minority groups

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5
Q

What are some social risk factors for TB?

A
  • Incarceration facilities
  • Poverty
  • Overcrowding
  • Homelessness
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6
Q

What are some medical risk factors for TB?

A
  • Immunodeficiency (HIV, AIDS)
  • Excessive alcohol
  • Tobacco smoking
  • Drugs
  • Malignancies
  • Diabetes
  • End-stage renal disease
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7
Q

How is TB transmitted?

A

Through aerosol droplets which can stay in the air for several hours

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8
Q

What happens during the primary infection of TB?

A

M. tuberculosis is inhaled and engulfed by alveolar macrophages, but the pathogen destroys macrophages and causes pneumonitis

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9
Q

What is the Ghon complex?

A

Radiographic finding for pulmonary TB

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10
Q

What is the Ranke complex?

A

Later manifestation of Ghon complex

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11
Q

What is the immune response to TB infection?

A

An immune cascade forms granulomas to contain pathogens, maintaining latency

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12
Q

What is the incubation period for Latent Tuberculosis Infection?

A

Ranges from a few weeks up to 2 years

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13
Q

What typically triggers the activation of LTBI?

A

Another infection or medical conditions that cause immunosuppression

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14
Q

What happens when M. tuberculosis multiplies and breaks out of granulomas?

A

Free pathogens travel via lymphatic vessels to regional lymph nodes

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15
Q

How can pathogens spread from lymph nodes to other organs?

A

Hematogenously

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16
Q

Which organs can be affected by the spread of TB pathogens?

A
  • Kidneys
  • Long bones
  • Vertebrae
  • Brain
  • Meninges
  • Eyes
17
Q

What are the two types of TB presentations?

A

Pulmonary TB and extrapulmonary TB.

18
Q

What is the most common symptom of pulmonary TB?

A

Productive cough, sometimes with haemoptysis.

19
Q

What are additional symptoms of pulmonary TB?

A

Pleuritic chest pain, malaise, drenching night sweats, fever, weight loss.

20
Q

What are the symptoms of extrapulmonary TB?

A

Organ-specific symptoms.

21
Q

What is the primary aim of TB investigation?

A

To distinguish active and latent TB.

22
Q

What histological finding is associated with TB?

A

Caseating granulomas.

23
Q

What are the two main lab tests to diagnose exposure to TB?

A

Tuberculin skin test (TST) and Interferon Gamma Release Assay (IGRA).

24
Q

What is the Tuberculin skin test (TST)?

A

An intradermal injection of tuberculin that induces a delayed hypersensitivity reaction.

Result is measured by the diameter of erythema circling induration 48-72 hours after injection.

25
Q

What is the Interferon Gamma Release Assay (IGRA)?

A

A blood test that measures T-cell release of interferon-y in response to TB-specific antigens.

Example: Quantiferon-TB.

26
Q

What are the gold standard lab tests for diagnosing active TB?

A

Smear test and Nucleic acid amplification testing (NAAT).

27
Q

What does the smear test involve?

A

Three sputum specimens collected 8 to 24 hours apart for acid-fast bacilli (AFB) smears and cultures.

Latent TB cultures and smears are negative, but active TB are positive.

28
Q

What is the purpose of Nucleic acid amplification testing (NAAT)?

A

To aid in the detection of M. tuberculosis genetic material using sputum culture.

Used if smear test is inconclusive.

29
Q

What is the diagnosis if both smear test and NAAT are positive?

A

Active pulmonary TB.

30
Q

Where does TB primarily affect in the lungs?

A

Upper lobe.

31
Q

What tests should be performed for active extrapulmonary TB?

A

AFB smear microscopy, culture, NAAT, and histopathology on affected tissues and fluids.

32
Q

What is the management for TB?

A

Antitubercular drugs.

33
Q

What is the treatment for latent TB?

A

3 months of isoniazid and rifampicin or 6 months of isoniazid.

Better for HIV and transplant patients.

34
Q

What is the treatment for single drug-resistant TB?

A

4-drug therapy with different combinations of RIPE.

35
Q

What is the treatment for multidrug resistant TB?

A

At least 6-drug therapy.

36
Q

What is the standard treatment for active TB?

A

2 months of RIPE followed by a 4-10 months continuation phase with rifampicin and isoniazid.

37
Q

What is Directly Observed Treatment?

A

A method to ensure patients take their medications.

Clinical lectures: Yr2 (41 decks)

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