Tuberculosis

Question 1

What is tuberculosis?

Answer 1

Multi-system infectious disease, commonly involving the respiratory tract
Airbone spread of mycobacterium

Question 2

Of those exposed to mycobacterium tuberculosis; how many develop latent vs. immediate active TB?

Answer 2

90% latent

10% immediate, active

Question 3

What type of bacteria is mycoplasma tuberculosis?

Answer 3

Acid-fast bacilli

Question 4

How is tuberculosis diagnosed?

Answer 4

PCR
Histology
Microscopy of sputum
Ziehl-Neelson stain - red = positive for apical bacteria

Question 5

Apical disease is most likely secondary to TB

Apical lesion called?

Answer 5

Assmann focus (BUZZ)

Question 6

What are respiratory clinical features of TB?

Answer 6

Gradual onset
Cough
Sputum
Malaise
Weight loss 
Night sweats
Haemoptysis
Breathlessness
Upper zone crackles

Question 7

What are meningeal features of TB?

Answer 7

Headache
Drowsy
Fits

Question 8

What are GI symptoms of TB?

Answer 8

Pain
Bowel obstruction
Perforation
Peritonitis

Question 9

What are spinal symptoms of TB?

Answer 9

Pain
Deformity
Paraplegia

Question 10

What are non-resp/GI/spinal/meningeal features of TB?

Answer 10

Pericardial tamponade
Renal failure 
Lymphadenopathy
Cold abscess
Septic arthritis 
Hypo-adrenalism

Question 11

How can previous exposure to TB be tested for?

Answer 11

Interferon Gamma Release Assay

Mantoux (tuberculin test)

Question 12

How is TB managed?

Answer 12

4 months of 
- Rifamipicin
- Isoniazid 
- Ethambutol
- Pyrazinamide 
2 months of 
- Rifampicin
- Isoniazid

Question 13

What are side effects of Rifampicin?

Answer 13

Turns all bodily fluids orange

Makes steroids, hormonal contraception, opiates analgesics and many other drugs ineffective

Question 14

Haematological dissemination via the pulmonary vein (BUZZ) leads to?

Answer 14

Systemic spread to the spleen, liver and kidneys

Question 15

Haematological dissemination via pulmonary artery leads to`

Answer 15

Miliary dissemination in the lungs

Question 16

The Mantoux test gives a false positive with?

Answer 16

BCG

Question 17

What is the BCG vaccination?

Answer 17

Attenuated strain of M. bovis

Question 18

Tuberculosis diagnosis must be reported to?

Answer 18

Public health

Question 19

What are the side effects of Rifampicin?

Answer 19

Hepatitis
Orange-red urine (all body fluids)
Flu syndrome

Question 20

What are the side effect of Isoniazid?

Answer 20

Hepatitis

Peripheral neuropathy

Question 21

What are the side effects of Pyrazinamide?

Answer 21

Hepatitis
Anorexia + vomiting
Hyperuricaemia

Question 22

What are the side effects of Ethambutol?

Answer 22

Colour blindness - Blindness

Arthralgia