Tuberculosis

Question 1

Pathology of tuberculosis?

Answer 1

Inflammatory response (Type IV), formation of granuloma

Question 2

How does TB differ between immunocompetent and immunocompromised individuals?

Answer 2

Usually contained in healthy individuals; may disseminate in immunocompromised (miliary TB)

Question 3

Causes for reactivation? (3)

Answer 3

Immunosuppressive drugs
HIV
Malnutrition

Question 4

Sites of extra-pulmonary secondary TB? (5)

Answer 4

CNS (tuberculous meningitis)
Vertebral bodies (Pott's disease)
Cervical lymph nodes (scrofuloderma)
Kidneys
GI tract

Question 5

What test is used to detect latent TB?

Answer 5

Mantoux test- injection of purified protein derivative.

Question 6

Interpretation of Mantoux?

Answer 6

Negative- previously unvaccinated people may be given BCG

Positive- previous TB infection/BCG, do not give

Strongly positive- suggests TB infection

Question 7

Treatment of active tuberculosis a) first 2/12 b) next 4/12

Answer 7

a) Rifampicin, Isoniazid, Pyrazinamide, Ethambutol

b) Rifampicin, Isioniazid

Question 8

Treatment for latent tuberculosis?

Answer 8

Isoniazid 6/12

Question 9

Who is the BCG vaccine given to?

Answer 9

High-risk infants

Question 10

The use of which medications are associated with risk of TB reactivation?

Answer 10

Anti-TNF mAb e.g. infliximab

Question 11

Rifampicin side effect?

Answer 11

Hepatitis

Question 12

Isoniazid side effects? (2)

Answer 12

Neuropathy

Hepatitis

Question 13

What is the name of the lesion caused by primary TB infection?

Answer 13

Ghon focus

Question 14

Ethambutol side effects? (2)

Answer 14

Optic neuritis, red-green colour blindness