Tuberculosis Flashcards
what is it
infectious disease of resp tract
type 4 hypersensitivity - caseating granulomas and caseous necrosis
what happens during primary exposure (1st time)
affects hilar lymph nodes
granulomatous due to immune activation
what happens during secondary exposure (2nd time)
fibrosing and cavitating apical lesions due to overactive T cell response
this is the reactivation of latent TB
what are causes
mycobacterium tuberculin
m. bovis
what are resp symptoms
cough
haemoptysis
upper lobe crackles
dyspnoea
what are GI symptoms
peritonitis
perforation
bowel obstruction
pain
what are spinal symptoms
pain
deformity
paraplegia
what are meningeal symptoms
drowsy
headache
fits
what are other symptoms
renal failure weight loss night sweats lymphodenopathy and cold abscess pericardial temponade septic athritis and hypoadrenalism
how is it diagnosed
CXR and ZN stain of sputum for acid and alcohol fast bacilli
what does CXR look like
upper lobe prominance, cavity formation, tissue destruction, scarring and shrinkage, heals with calcification
when does the CXR contain bilateral infiltrates and reticulonodular shadowing
presence of ARDS/miliary TB - result of tubercle bacilli in blood stream
what is treatment
2 months RIPE (rifampicin, isoniazid, pyradizamide and ethambutol)
4 months RI
what is side effect of rifampicin
stains fluids pink/orange
break opiate and steroids (the pill)
rarely hepatitis
what is side effect of isoniazid
polyneuropathy