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Respiratory Block > Tuberculosis > Flashcards

Tuberculosis Flashcards

1
Q

How many people are infected with TB worldwide?

A

2 billion

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2
Q

What number is it ranked in deaths due to infectious disease worldwide?

A

second

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3
Q

How many new cases are there annually?

A

8.6M

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4
Q

Until when was TB in the UK thought to be under control?

A

The mid 1980s due to immigration

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5
Q

Why is TB a major problem in London?

A

Immigration from a high incidence area

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6
Q

What organism is responsible for causing TB?

A

mycobacteria

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7
Q

Where is mycobacteria ubiquitous?

A

The soil and water

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8
Q

What does mycobacteria bovis cause?

A

Bovine TB

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9
Q

What does mycobacteria leprae cause?

A

leprosy

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10
Q

Briefly give a description of mycobacteria

A

very slow growing non motile bacillus which is aerobic

very thick cell wall

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11
Q

What is mycobacteria resistant to?

A

acid, alkali, detergents, neutrophils and macrophage destruction due to being accustomed to tough soil environment

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12
Q

How is mycobacterium tuberculosis transmitted?

A

Open Tb - coughing and sneezing

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13
Q

Why can TB not be transmitted outside?

A

The mycobacteria are eliminated by UV are undergo infinite dilution

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14
Q

Do large or small inhaled droplets do more harm?

A

Small as large nuclei are cleared but small impact the alveoli and slowly proliferate

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15
Q

How is mycobacterium bovis transmitted?

A

drinking infected cows milk and deposited in cervical lymph nodes although this is rare now due to the pasteurisation of milk

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16
Q

Briefly describe the immunological pathway

A

T helper cells from the lymph nodes undergo clonal selection due to being activated by the antigen on the antigen presenting cell and migrate to the alveolus where they activate macrophages forming epitheliod cells and causing tissue damage

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17
Q

What does the accumulation of macrophages, epitheliod and langhans cells form?

A

Granulomas

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18
Q

What is a characteristic feature of TB

A

Central caseating necrosis which may later calcify

19
Q

State one negative and one positive of the Th1 mediated immunological response

A

eliminates and reduces number of mycobacteria

Tissue destruction

20
Q

Name the 2 factors that influence the outcome of infection

A

Infection

Susceptibility

21
Q

Name the 2 factors of infection

A

virulence

number

22
Q

Name the 5 components of susceptibility

A 
Age
immunosuppression 
Nutrition
race 
genetics
23
Q

What is primary infection?

A

No preceding exposure or immunity

24
Q

Who is usually affected by primary infection?

A

children

25
Q

Name some symptoms of primary infection

A

usually none
can be fever and malaise
erythema nodosum

26
Q

What is primary infection associated with?

A

The development of immunity to tuberculoprotein

27
Q

Briefly describe what happens if the primary infection progresses

A

cavitation and lobar collapse due to enlarged hilar lymph

Lymph node discharge into bronchus

28
Q

Describe 2 mechanisms of post primary disease

A

reactivation of mycobacterium from latent primary infection

New reinfection from outside source

29
Q

List the 3 key findings in CXR for TB

A

Patchy
calcified
cavitation

30
Q

Why is multiple drug therapy essential for TB?

A

Single agent treatment leads to drug resistant organisms in 14 days

31
Q

How long must therapy continue for?

A

6 months

32
Q

What are you legally required to do with TB?

A

Notify all cases

33
Q

What should you test someone with TB for?

A

HIV

34
Q

What is the treatment plan for TB?

A

4 medications for 2 months and 2 medications for 4 months

35
Q

What 4 medications are used?

A

rifampicin
isoniazid
ethambutol
pyrazinamide

36
Q

What 2 medications are used in the last 4 months

A

rifampicin

isoniazid

37
Q

What are the adverse affects or rifampicin?

A

Orange irn bru tears and urine
hepatitis
oral contraceptive pill ineffective

38
Q

What are the adverse effects of isoniazid?

A

hepatitis

peripheral neuropathy

39
Q

What is the adverse effect of ethambutol?

A

peripheral neuropathy

40
Q

What is the adverse effect of pyrazinamide?

A

Gout

41
Q

What is gout?

A

Severe pain in joints

42
Q

How many people exposed will develop TB?

A

1 in 6

43
Q

What are the 2 criteria meaning there should be no immunity to tuberculoprotein?

A

under 16

no BCG

44
Q

What are the 3 initial investigations for TB?

A

CXR
bronchoscopy
sputum examination

Respiratory Block (29 decks)

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