Tuberculosis Flashcards
What is the pathophysiology in primary TB?
Usually an individual gets infected and the infection is walled off by macrophages forming a ghon focus, there is also hilar lymph node involvement
Immunocompromised may develop miliary TB instead
What is the pathophysiology for secondary TB?
If the host becomes immunocompromised then the TB can reactivate
Common causes of reactivation:
-HIV
-Immunosupressive drugs such as steroids
Where are the locations you can get extrapulmonary TB?
central nervous system (tuberculous meningitis - the most serious complication) vertebral bodies (Pott's disease) cervical lymph nodes (scrofuloderma) renal gastrointestinal tract
How is screening for latent TB usually done?
Mantoux test, protein derivative is injected into skin to look for reaction
Interferon gamma blood test can also be done
What is the treatment for active TB?
RIPE For 2 months: Rifampicin Isoniazid Pyrazinamide Ethambutol Continue for next 4 months: Pyrazinamide Ethambutol
How is latent TB treated?
With Rifampicin and isonaizid
How is meningeal TB treated?
With a 12 month course of RIPE with the addition of steroids Rifampicin Isoniazid Pyrazinamide Ethambutol
What are some of the factors that might increase risk of TB reactivation?
silicosis chronic renal failure HIV positive solid organ transplantation with immunosuppression intravenous drug use haematological malignancy anti-TNF treatment
Which Tb treatment is associated with peripheral neuropathy?
Isoniazid
