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Respiratory system SA > Tuberculosis > Flashcards

Tuberculosis Flashcards

1
Q

What is the effect of Tuberculosis worldwide

A

Second leading cause of death from infection

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2
Q

What is the responsible organism that causes TB

A

Mycobacterium TB

Slow growing with a thick cell wall composed of lipids, peptidoglycans, arabinomannans (polysaccharide)and found in the soil

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3
Q

Where is TB usually located in the lungs

A

located upper zones or apex of lower lobes

as mycobacterium like living in aerobic conditions

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4
Q

How is mycobacterium detected

A

Acid - and alcohol - fast bacilli (AAFB)

Ziehl Neilson stain

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5
Q

How is mycobacterium TB transmitted

A

as an airborne droplet

Inhaled and deposited into alveoli

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6
Q

What environment is TB more likely to be transmitted in and why

A

More likely to be transmitted inside, as outdoors mycobacteria eliminated by UV radiation and infinite dilution

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7
Q

What are two types of mycobacterium

A

Mycobacterium TB

Mycobacterium bovis

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8
Q

What is the transmission and pathology of Mycobacterium bovis

A

Consumption of Infected cows’ milk, deposited in cervical, intestinal lymph nodes

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9
Q

What is the pathology of the TB infection result in a Th1 cell mediated response

A 
TB infection in the alveoli,
Macrophages digest TB, 
Macrophage go to the lymph node
Presents itself to Th1 cells, 
TH1 cells move toward infection 
proliferating and activate macrophages
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10
Q

How does granulomas form from a TB infection

A

TB is resistant to macrophage breakdown,
Accumulation of macrophages results in epithelioid and; Langhan’s cells formation
This creates a GRANULOMA

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11
Q

How does Central caseating necrosis occur in TB

A

Tissue damage - caused by the activated macrophages

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12
Q

What is a redeeming factor in the Th1 cells mediated response in fighting TB infection

A

Eliminates / Reduces number of invading mycobacteria

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13
Q

What factors effect the outcome of the infections

A

Virulence
Susceptibility

Duration of contact
Intensity of infection

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14
Q

What is immune pathology of primary TB infection if the host is susceptible and primary infection results in a progressive disease

A
  • Tissue destruction
  • Organism proliferates (cavitation)
  • progressive disease

Spread via lymphatics entering first and enlarging the hilar lymph nodes

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15
Q

What is the possible outcome of enlarged hilar lymph nodes as a result of progressive TB

A

compress bronchi,
lobar collapse
Discharges into bronchus and cause TB bronchopneumonia

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16
Q

When would TB be considered primary infection

A

If you previously haven’t been exposed or immunised against TB

17
Q

What is the majorty of outcome with primary TB infection

A

Initial leison
spreads to local lymph nodes
Heals with or without scar
develop an immunity to tuberculoprotein

18
Q

What is the potentially outcome if the TB primary infection lies dormant for 6-12months in order of severity

A

Military TB
Meningeal TB
Tuberculous pleural effusion

19
Q

What is present in military TB

A

widespread small granulomas

20
Q

Where does Meningeal TB affect and what is increased

A

Increases protein content in the cerebral final fluid of the meninges = meningitis

21
Q

When would TB be classed as a post primary disease

A

Reactivation of mycobacterium from latent primary infection
OR
A new re-infection from outside source

22
Q

Why does TB infections causing post primary diseases typically take 1-5 years to appear

A

Is a slow and progressive process

23
Q

What is the symptoms of post primary disease TB

A 
malaise,
fever, 
weight loss 
cough, 
sputum, 
haemoptysis, 
pleuritic pain 
Dysnopea 
Erythema nodosum,
24
Q

Whos is clinically at a high risk of developing the post primary disease from TB exposure

A 
Diabetics 
elderly / adolescence 
Immunosuppressed patients 
 - HIV Patients 
 - Steroid patients 
Malignancy 
Immigrants high incidence area  
alcoholics 
IVDA
poor social circumstances 
malnourished
25
Q

There is usually no signs but what are the possible signs of an advanced TB

A

may be crackles,
bronchial breathing.
Finger clubbing is rare unless very chronic infection

26
Q

What are the investigations carried out in the diagnosis of TB

A 
Sputum microbiology (Culture, PCR, Smear)
Chest Xray 
Bronchoscopy 
Pleural aspiration + biopsy 
CT scan of thorax
27
Q

What does the chest x ray look like for a patient with TB

A

Patchy located upper zones or apex of lower lobes

Cavitation present if advanced

Calcification seen in healed or chronic TB

28
Q

What is the modern day treatment for TB

A

Multiple drug therapy for at least 6 months

Two Months:
Rifampicin 
Isoniazid 
Ethambutol 		 
Pyrazinamide

Four Months:
Rifampicin
Isoniazid

29
Q

What is the most important factors in the management and treatment of TB

A

legal requirement to notify all cases

HIV testing necessary

30
Q

When are rendered no infectious from TB

A

two weeks after treatment

31
Q

What is the possible side effects of rifampicin

A

Orange ‘Irn Bru’ urine, tears

Induces liver enzymes to increase the metabolism of prednisolone, anticonvulsants

Oral contraceptive pill ineffective

Hepatitis

32
Q

What is the possible side effects of Isoniazid

A

Hepatitis

Peripheral neuropathy

33
Q

What is the possible side effects of Ethambutol

A

Optic neuropathy

34
Q

What is the possible side effects of Pyrazinamide

A

Gout

35
Q

What is the purpose of TB contact tracing

A

Identify source

Identify transmission

36
Q

Having a BCG gives you what

A

immunity to tuberculoprotein

By injecting weakened mycobacterium bovis

37
Q

What tests is used to screen if you have been exposed to TB

A

Heaf
Mantoux
Inject TB antigen PPD, red bump appears within two days if had previous exposure

38
Q

What is the 3 different pathologies from primary TB infection

A
  • Heal and develop immunity
  • Progressive disease
  • Lies dormant 6-12months (Meningeal/ Military/Pleural effusion TB)

Respiratory system SA (37 decks)

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