Tuberculosis Flashcards

1
Q

what is tuberculosis

A

multisystem airborne infection specifically affecting respiratory tract

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2
Q

what species typically causes TB

A

mycobacterium

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3
Q

TB causes caseating/non-caseating granulomatous disease

A

caseating with necrotic centre

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4
Q

describe what is commonly seen on CXR of TB

A

subpleural primary lesion within the lungs

Gohn focus

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5
Q

when would active infection occur

A

when T cell or macrophage response is inadequate

can either be the primary infection or can be reactivation of latent disease

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6
Q

describe latent disease

would a patient still experience symptoms

A

infection present with no disease

patient is asymptomatic

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7
Q

what are the symptoms of active TB

A

persistent productive cough, weight loss, fever, fatigue, night sweats, possible haemoptysis - also GI symptoms
MUST ask about foreign travel

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8
Q

what investigations are done to diagnose TB and what do they show

A

CXR - Gohn focus, consolidation, fibrosis and enlarged hilar lymph nodes
obtain tissue through biopsy

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9
Q

what is the gold standard investigation for diagnosing TB

A

PCR

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10
Q

alongside PCR, what other tests can be performed

A

culture - time consuming

Ziehl-Neelson

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11
Q

what test is used to diagnose latent TB

A

tuberculin skin test

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12
Q

when would you get a false negative tuberculin skin test

A

after BCG vaccine

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13
Q

what 4 drugs are used to treat TB

A

rifampicin
isoniazide
pyrazinamide
ethambutol

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14
Q

what is the treatment for active TB

A

treat with RIPE for 2 months

followed by RI for 4 months

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15
Q

what are side effects of rifampicin

A

hepatitis

red/orange urine

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16
Q

what are side effects of isoniazide

A

neuropathy

17
Q

what are side effects of pyrazinamide

A

hepatic toxicity and decreased renal excretion

18
Q

what are side effects of ethambutol

A

colour blindness leading to blindness

19
Q

what is the treatment for latent TB

A

3 months on RI
6 further months on I
but depending on ability to tolerate side effects

20
Q

what is miliary TB

A

TB that has poor management by hilar lymph nodes and has spread through the bloodstream

21
Q

what does interferon gamma testing show in TB

A

levels of IFG released from T cells

22
Q

at what stage would latent TB most likely activate

A

when the patient becomes immunocompromised either due to HIV or immunosuppression