Tuberculosis

Question 1

What is the classic microscopy finding in TB?

Answer 1

Acid fast bacilli on Ziehl-Neelson staining

Question 2

What is the classic histology finding in TB?

Answer 2

Granulomata with central caseous (cheesy) necrosis

Question 3

What is typically seen on CXR?

Answer 3

fibronodular opacities in upper lobes +/- cavitation

Question 4

What test can be done for rapid diagnosis of TB?

Answer 4

nucleic acid amplification tests (NAAT)

Question 5

What is the treatment for TB?

Answer 5

2 months RIPE 4 months RI
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol

Question 6

What are the side effects of Rifampicin?

Answer 6

Red/orange secretions/urine

Question 7

What are the side effects of isoniazid?

Answer 7

Peripheral neuropathy (glove and stocking distribution)

Question 8

What are the side effects of Pyrazinamide?

Answer 8

Increased uric acid (gout)

Arthralgia

Question 9

What are the side effects of Ethambutol?

Answer 9

Visual problems (optic neuritis, colour vision first sign)

Question 10

What is the name for an apical TB lesion in the lung?

Answer 10

Assmann focus

Question 11

What is miliary TB?

Answer 11

Spread of TB in the bloodstream

• miliary dissemination into lung by pulmonary artery
• -> pulmonary vein –> systemic dissemination

Question 12

What is a Ghon focus?

Answer 12

Area of infection and cased necrosis at periphery of the lung, beneath the pleura

Question 13

What is the radiological sign of endobronchial TB?

Answer 13

Tree-in-bud sign (also seen in other pathologies)