Tuberculosis

Question 1

What is the pathophysiology?

Answer 1

Obligate anaerobes which are relatively impermeable due to thick membrane cause infection
Mycobacterium tuberculosis
Mycobacterium bovis

Question 2

What are the symptoms?

Answer 2

Fever 
Malaise
Often no symptoms
Cough
Haemoptysis

Question 3

What are the signs?

Answer 3

Erythema nodosum
Crackles
Bronchial breathing

Question 4

What are the investigations

Answer 4

SPUTUM SPECIMEN - 3 cultures on successive days
CHEST X-RAY - Patchy shadowing, cavitation, calcification
CT SCAN
BRONCHOSCOPY WITH BRONCHOALVEOLAR LAVAGE - culture, biopsy histology
PLEURAL ASPIRATION AND BIOPSY - fluid cytology, fluid for AAFB and and culture, biopsy histology and 1 biopsy in saline for culture

Question 5

What is the treatment?

Answer 5

Sometimes surgery
Ethambutol and pyrazinamide for 2 months
Rifampicin and isoniazid for 6 months
Must report all cases and contact tracing must occur