Tuberculosis

Question 1

TB: Define

Answer 1

TB is a bacterial infection - Mycobacteria - that is spread through inhaling tiny droplets from coughs or sneezes of an infected person. It mainly affects the lungs.

Question 2

TB: Symptoms

Answer 2

Cough = 3 weeks +
Chest pain
Haemoptysis 
Unintentional Weight Loss
Fatigue 
Fever 
Night Sweats 
Shaking Chills

Question 3

TB: Signs

Answer 3

Maybe none
If chronic:
Bronchial Breathing
Crackles

Question 4

TB Screening:

Answer 4

If < 16 yrs & no BCG = Tuberculin Test (Heaf/Montoux)
If > 16 yrs & BCG, Do CXR, if normal discharge, if abnormal investigate for TB
If Heaf Positve, and exposed to TB, repeat test after 6 weeks

Question 5

TB Investigations:

Answer 5

3 Sputum Specimens on 3 Successive Days:
Suptum Smear, Sputum Culture, Suptum Sample
Biopsy
Bronchoscopy
CXR - Consolidation, Cavitation, Calcification, Fibrosis
CT of Thorax
Pleural Aspiration
All patients with suspected TB require a HIV Test, latent TB, is often pushed into active disease by immunosuppression and the most common cause of this is HIV.

Question 6

TB Treatment:

Answer 6

For the first 2 months = Rifampicin, Isoniazid, Pyrazinamide, Ethambutol.
For the next 4 months = Rifampicin & Isoniazid.

Question 7

TB Treatment Side Effects:

Answer 7

Rifampicin = hepatitis, orange body fluids, tearful, hot
Isoniazid = hepatitis, peripheral neuropathy
Pyrazinamide = gout
Ethambutol = optic neuropathy