Tuberculosis Flashcards

1
Q

what is it

A

infectious disease of resp tract

type 4 hypersensitivity - caseating granulomas and caseous necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what happens during primary exposure (1st time)

A

affects hilar lymph nodes

granulomatous due to immune activation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what happens during secondary exposure (2nd time)

A

fibrosing and cavitating apical lesions due to overactive T cell response
this is the reactivation of latent TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are causes

A

mycobacterium tuberculin

m. bovis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are resp symptoms

A

cough
haemoptysis
upper lobe crackles
dyspnoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are GI symptoms

A

peritonitis
perforation
bowel obstruction
pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are spinal symptoms

A

pain
deformity
paraplegia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are meningeal symptoms

A

drowsy
headache
fits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are other symptoms

A
renal failure 
weight loss
night sweats 
lymphodenopathy and cold abscess 
pericardial temponade 
septic athritis and hypoadrenalism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how is it diagnosed

A

CXR and ZN stain of sputum for acid and alcohol fast bacilli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what does CXR look like

A

upper lobe prominance, cavity formation, tissue destruction, scarring and shrinkage, heals with calcification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

when does the CXR contain bilateral infiltrates and reticulonodular shadowing

A

presence of ARDS/miliary TB - result of tubercle bacilli in blood stream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is treatment

A

2 months RIPE (rifampicin, isoniazid, pyradizamide and ethambutol)
4 months RI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is side effect of rifampicin

A

stains fluids pink/orange
break opiate and steroids (the pill)
rarely hepatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is side effect of isoniazid

A

polyneuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is side effect of pyradizamide

A

hepatic toxicity, reduces renal excretion of urate and may precipitate gout

17
Q

what is side effect of ethambutol

A

optic neuritis, red/green colour blindness

18
Q

how can it be prevented

A

BCG vaccine - reduces risk by 70%

contact tracing

19
Q

what is latent TB

A

symptom free, granulomas, -ve cultures, leave alone

20
Q

what reactivates latent TB

A

steroids, immunosuppression and anti-TNF

21
Q

what is anti-TNF

A

used to treat rheumatoid athritis, crohns, psoriasis, alkylasing spondylitis
if have latent TB - give 6 months of I or 3 months of RI before starting anti-TNF