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Oxford MRCS Pathology > Tuberculosis (29) > Flashcards

Tuberculosis (29) Flashcards

1
Q

A young Indian lady came back from a foreign travel with cervical lymphadenopathy (anterior triangle mass), loss of weight, night sweating.

What are the possible causes of cervical lymphadenopathy?

A
  • Hodgkin’s lymphoma (more common in this age group)
  • Tuberculosis (TB)
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2
Q

Which labs should be used for sputum examination?

A

Microbiology and cytology labs
ziehl neelsen stain

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3
Q

How should sputum specimens be labelled?

A

Category-B UN3373

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3
Q

What are the culture media for mycobacteria?

A
  • Solid media: Lowenstein Jensen media, Middlebrook media
  • Liquid media: BACTEC/MIGT (mycobacteria growth indicator tube)
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3
Q

Where should sputum specimens be placed?

A

In a biohazard bag

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3
Q

What are the tests for TB?

A
  • Sputum examination (culture, Ziehl-Neelsen stain)
  • Mantoux test
  • PCR to differentiate Mycobacterium tuberculosis from other species
  • QuantiFERON (interferon gamma assays)
  • Fine-needle aspiration cytology (FNAC) of lymph node
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4
Q

What are the organisms causing TB?

A
  • Mycobacterium tuberculosis
  • Mycobacterium avium intracellulare (MAC) for disseminated infection in immunocompromised patients
  • Mycobacterium bovis
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5
Q

How long does it take to culture mycobacteria?

A

1-8 weeks

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5
Q

What can be inferred from the FNAC result: necrotic tissue, histiocytes, giant cells?

A

TB

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6
Q

What type of protein deposition is related to TB?

A

Amyloid

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7
Q

What are giant cells?

A

Multinucleated cells comprising macrophages often forming granuloma (e.g. Langerhans’ giant cells, Reed Sternberg cells)

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8
Q

What are the public health and community concerns related to TB?

A
  • Notify the consultant in communicable disease control (CCDC)
  • Avoid working in the food factory
  • Use a mask during sneezing or coughing
  • Directly Observed Treatment, Short-course (DOTS) anti-TB therapy
  • Contact tracing: the identification and diagnosis of persons who may have come into contact with an infected person
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9
Q

What is the advice to contacts?

A

Counselling, screening, and treatment of other family members

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9
Q

What is a granuloma?

A

An organized collection of macrophages fusing to form Langerhans’ giant cells.

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10
Q

What are the other causes of granuloma?

A
  • Leprosy
  • Schistosomiasis
  • Sarcoidosis
  • Crohn’s
  • Rheumatoid arthritis
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Oxford MRCS Pathology (34 decks)

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