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Med Spec (Infectious Diseases) > Tuberculosis > Flashcards

Tuberculosis Flashcards

1
Q

What stain is used to test for acid fast bacilli?

A

Ziehl-Neilson stain

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2
Q

In those with suspected TB, how are samples for microscopy and culture taking in patients who cannot produce sputum?

A

Bronchoscopy/bronchoalveolar lavage

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3
Q

What will histology of a lung biopsy of someone with TB show?

A

Caseating granulomas and acid fast bacilli

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4
Q

What is the standard treatment regimen for active TB?

A

2 months of rifampicin, isoniazid, pyrizinamide and ethambutol; 4 months of rifampicin and isoniazid

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5
Q

What is a fairly common side effect of many anti-TB drugs, and what is the best blood test to monitor for it?

A

Hepatitis- monitor LFTs

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6
Q

What are the two tests that can be used to screen for evidence of current/previous infection with TB?

A

Mantoux test, interferon gamma release blood tests

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7
Q

If the screening tests for TB are positive, what is the next investigation used to assess for evidence of active TB?

A

CXR

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8
Q

Describe how a Mantoux test can often cause false positives?

A

Those who have had the BCG

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9
Q

Describe how a Mantoux test can often cause false negatives?

A

Those with miliary TB

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10
Q

What are some common CXR findings of TB?

A

Upper lobe shadowing and cavitation; mediastinal lymph node enlargement

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11
Q

What is the most important microbiological test for TB?

A

Sputum sample for acid-fast bacilli and culture

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12
Q

How many samples of sputum should be taken for testing for acid-fast bacilli?

A

3 morning samples

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13
Q

On a CXR, the presence of what suggests primary TB?

A

Ghon complex, a ghon focus and hilar lymphadenopathy

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14
Q

On a CXR, the presence of what suggests secondary TB?

A

A fibrosing and cavitating apical lesion

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15
Q

TB most commonly presents as a history of systemic disturbance lasting how long?

A

Weeks-months (subacute)

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16
Q

Name the most common systemic features of TB?

A

Weight loss, fever, malaise and night sweats

17
Q

What are the most common respiratory features of TB?

A

Cough and haemoptysis

18
Q

What organism is responsible for the vast majority of cases of TB?

A

Mycoplasma tuberculosis

19
Q

M. bovis is a rare cause of TB- how is it acquired?

A

Drinking infected cow’s milk

20
Q

What is meant by the term miliary TB?

A

Active TB which is disseminated around the body via haematological spread

21
Q

Multi-drug resistant TB describes TB which is resistant to which antibiotics?

A

Rifampicin and isoniazid

22
Q

What are the chances that latent TB will progress to active TB?

A

5% risk of progression to active disease within two years of infection; 5% lifetime risk of reactivation thereafter

23
Q

Where in the world is the incidence of TB highest?

A

Asia and sub-Saharan Africa

24
Q

Name some high risk groups for TB infection?

A

Birth in high incidence countries, immunosuppresion, overcrowding/homelessness

25
Q

What vaccination is used to try to prevent TB?

A

BCG

26
Q

What are the two treatment options for latent TB?

A

6 months of isoniazid OR 3 months of isoniazid and rifampicin

27
Q

How is TB spread?

A

Respiratory droplets

28
Q

What is the key histological feature of TB and what is this known as?

A

Caseating granulomas, known as a Gohn focus

29
Q

What type of hypersensitivity reaction is TB?

A

Type IV

30
Q

Which anti-TB drug is a liver enzyme inducer?

A

Rifampicin

31
Q

Which anti-TB drug is a liver enzyme inhibitor?

A

Isoniazid

32
Q

What is the major side effect of ethambutol to be aware of?

A

Optic neuritis

33
Q

Which anti-TB drug causes orange secretions?

A

Rifampicin

34
Q

Which anti-TB drug causes gout, arthralgia and myalgia?

A

Pyrizinamide

35
Q

Which anti-TB drug causes peripheral neuropathy? How is this prevented?

A

Isoniazide- it is prevented by also taking pyridoxine (vitamin B6) alongside it

36
Q

Healed TB may cause persistent CXR changes. What are some examples of these?

A

Granulomas, apical scarring, pleural thickening

Med Spec (Infectious Diseases) (4 decks)

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