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Respiratory system > Tuberculosis > Flashcards

Tuberculosis Flashcards

1
Q

What is the organism that causes TB?

A

Mycobacterium tuberculosis, Mycobacterium bovine

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2
Q

What is the name of the organism that causes leprosy?

A

Mycobacterium leprae

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3
Q

Where do these organisms live?

A

In soil or water

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4
Q

What is specific about these bacteria?

A

They have very thick cell wall, resistant to acids, alkalis and detergents, very hard for macrophages and neutrophils to destroy them

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5
Q

What is the name for this group of antibiotics?

A

Acid alcohol fast bacteria

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6
Q

What is the growing patter of these organisms?

A

they are non.motile, very slowly growing and aerobic, found mostly in the apices of lungs

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7
Q

How is TB diagnosed for?

A

By ZN staining, red rods can be observed

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8
Q

Describe the spread of Mycobacterium tuberculosis

A

They are airborne, spread by sneezing, coughing, any respiratory droplets, large droplet nuclei in large airways, mostly cleared, small droplets gets to alveoli and proliferate, might cause infection

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9
Q

How is Mycobacterium bovid spread?

A

In the milk that is contaminated, deposited in the cervical and intestinal lymph nodes

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10
Q

What is the pathology of tuberculosis?

A

Macrophages are presented with the bacteria and engulf them, presents the antigens on their surface and migrate to lymph nodes where they present the antigens to the T cells, activated Th1 cells to the lungs again, activate macrophages which kill the bacteria but also tissue, activated macrophages will become epithelioid cells and Langhans giant cells

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11
Q

What is granuloma?

A

Accumulation of the epithelioid cells and Langhans cells, in TB it is caseating necrosis (cheese like), can calcify

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12
Q

What is susceptible host?

A

Old, poor nutrition, weak immune system, organisms proliferate and there is progressive disease

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13
Q

What is resistant host?

A

Young, healthy, there is initial tissue destruction, organisms are contained and no disease

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14
Q

What is primary TB infection?

A

In those not previously exposed or immunity, kids usually, in alveoli and lymph nodes, gut mainly. Bacteria to hillar lymph nodes and seeding to all organs (haematogenous seeding) lungs, bones, genitourinary system

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15
Q

What are the signs of primary infection?

A

Cough, enlarged lymph nodes in kinds, heals with or without scars, possible calcification. In adults usually no symptoms, erythema nodosum, may be fever, malaise, rarely chest signs. Healing with or without scars

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16
Q

What is Ghon focus and complex?

A

Primary lesion in TB, if it is in the hilar lymph nodes it is called complex

17
Q

What are the principles of TB testing?

A

Developed immunity for tuberculoprotein, intra-dermal administration of the protein, lymphatic and macrophage based response after 48 h

18
Q

What is the outcome of the primary infection?

A

Majority are cleared and cured, some stay latent, some with really bad immunity progressive disease

19
Q

What happens if the disease develops?

A

Focus enlarges, cavitation occurs, enlarged hillier lymph node, compressed bronchi, bronchial collapse, bursting of bronchi and discharge into bronchus - tuberculous bronchopneumonia, in others few moths after military TB fine mottling on x ray, widespread small granulomas, meningeal TB, CSF high protein, results in tuberculous pleural effusion

20
Q

What are the two post-primary infections?

A

Reactivation of mycobacterium from latent primary infection, disseminated in blood stream around body. Or new re-infection from outside source

21
Q

What sites can TB affect?

A

Bones, GI, joints, reproductive tract, pericardium, abdomen, adrenal glands, lymph nodes

22
Q

When do GI and cutaneous TB develop ?

A

10-15 years after

23
Q

When do pulmonary and skeletal symptoms of TB develop ?

A

1-5 years

24
Q

What are the symptoms of TB?

A

Cough, sputum production, pleuritic pain, haemoptysis, systemically unwell malaise, fever, weight loss, night sweats

25
Q

What are the risks for TB ?

A

Diabetes, immunosuppressive, TB, alcohol, drugs, poor social circumstances, immigrants

26
Q

What are the signs of TB?

A

May be none at all, hard to pick them up, HIV relationship

27
Q

What are the investigations for TB?

A

Sputum culture (3 on successive days, or inject saline and patients will cough), smear, chest x ray, CT, bronchoscopy with biopsy, pleural aspiration for culture, cytology and histology, interferon gamma release assay (patients infected will release interferon gamma)

28
Q

What would you observe on the chest X ray ?

A

patchy consolidation, usually apex and upper part, cavitation, may calcify

29
Q

What is the treatment of Tb?

A

Rifampicin, isoniazid for 2 months, rifampicin, isoniazid, ethambutol pyrazinamide for 4 months, DOT therapy

30
Q

What are the side effects of Rifampicin?

A

orange urine, tears, hepatitis, ineffective oral pills, induces enzymes for prednisolone, anticonvulsants

31
Q

What are the side effects of isoniazid?

A

hepatitis, peripheral neuropathy

32
Q

What are the side effects of ethambutol ?

A

optic neuropathy

33
Q

What is the side effect of pyrazinamide?

A

gout

34
Q

What has to be done if TB has been diagnosed ?

A

Remember to notify the authorities and do HIV test, identify the source and possible patients

35
Q

What is Mantoux test?

A

Intradermal injection of tuberculin, reading after 48-72 hours, induration bigger than 10 mm positive test

36
Q

What is the treatment if the heaf test in positive but the chest X ray is clear?

A

Chemophrophylaxis, rifampicin and isoniazid for 3 monts, isoniazid for 6 months

37
Q

What is the treatment if heaf is positive and X ray is abnormal?

A

treat as TB

38
Q

What is the procedure if the heaf is negative?

A

repeat after 6 weeks, if 2nd is negative give BCG, if positive treat as TB

Respiratory system (22 decks)

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