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Respiratory > Tuberculosis > Flashcards

Tuberculosis Flashcards

1
Q

bacteria that causes tuberculosis?

A

mycobacterium tuberculosis

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2
Q

why is mycobacterium tuberculosis protected from macrophages?

A

mycolic acid capsule

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3
Q

why must body form granuloma to section off TB, i.e. why can the macrophages just not kill the mycobacterium tuberculosis?

A

mycolic acid capsule

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4
Q

main transmission for mycobacterium tuberculosis ?

A

droplets

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5
Q

how does mycobacterium tuberculosis travel through the body systemically?

A

lymph (nodes)

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6
Q

4 statuses of TB infection, and define each.

A

primary - you first get it but contain via granuloma

latent - infection now harboured and you are asymptomatic

secondary - latent activates, happens in immunocompromised

miliary -spreads systemically

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7
Q

how many people have latent TB worldwide?

A

1.7 billion

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8
Q

Where globally is TB the most prevalent?

- 2 places

A

South Asia + Sub-Sahara Africa

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9
Q

can TB effect other organs aside the lungs?

A

yes

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10
Q

purpose of forming granuloma?

A

section off the TB so it can not spread

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11
Q

what does granuloma contain?

A

tubercle laden macrophages

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12
Q

% wise how many immunocompetent will successfully form granuloma to section off TB.

A

90%

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13
Q

risk factors for TB infection?

- 6

A

Homelessness
Alcohol/drugs/smoking
Immunocompromised: HIV, steroids use, malnutrition.
Silicosis: impairs macrophage

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14
Q

are people who get primary TB will usually asymptomatic.

A

yes, usually asymptomatic.

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15
Q

most serious complication of TB?

A

TB meningitis

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16
Q

someone has TB with cavity.

if cavity ruptures what complication will they now get?

A

pneumothorax

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17
Q

why is right middle lobe syndrome a complication of TB?

A

big hilar lymph nodes crush the R middle lobe

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18
Q

a latent TB reactivates in an immunocompromised person.

what type of TB is this called now.

A

secondary active TB

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19
Q

screening test for TB?

A

mantoux test

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20
Q

what is injected in the classic screening test for TB?

-name, how much, where, route

A

0.1ml PPD Tuberculin
arm
intradermally

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21
Q

on doing mantoux test how long do you wait before measuring the swelling?

A

48 hours

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22
Q

pt has mantoux test

swelling is <5mm.

interpretation?

A

negative

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23
Q

pt has mantoux test

swelling is 5-14mm.

A

positive

24
Q

pt has mantoux test

swelling is >14mm.

A

strongly positive

25
Q

HIV pt has mantoux test

swelling is 3mm.

is this is a negative result?

A

no because pt has HIV/

26
Q

a granuloma calcifies to form what?

and when this thing combines with hilar lymph nodes, what is it called then?

A

ghon lesion

ghon complex

27
Q

vaccine for TB and leprosy?

A

BCG

28
Q

4 people in which the BCG vaccine is contraindicated?

A

HIV
history of TB, +ve
Mantoux text
>35 years old

29
Q

3 people who should get BCG vaccine?

A

prisoners
healthcare workers
homeless

30
Q

typical systemic symptoms for TB, (common for lots of infections)?
-4

A

Fever
weight loss
night sweats
lymphadenopathy

31
Q

symptoms of TB?

- 8

A 
Haemoptysis 
Dyspnoea 
Cough with mucus
Chest pain 
fever
weight loss
night sweats
lymphadenopathy
32
Q

TB causes a cough.

is there or is there not mucus with the cough?

A

mucus is present

33
Q

TB causes haemoptysis.

typically is it small bleeding or lots of bleeding?

A

small amounts of blood

34
Q

auscultating on someone with TB,

what may heard (sometimes)?
-1

A

crackles

35
Q

you examine someone with TB.

what sign may be present for someone with long-standing TB

A

clubbing

36
Q

is CXR diagnostic for TB?

A

no

37
Q

is sputum culture diagnostic for TB?

A

yes

38
Q

CXR finding for someone with TB?

  • 3 things
A

upper zone cavities
consolidation
big hilar

39
Q

pt can not tolerate sputum sample.

what is 2nd line Ix that can be done instead?

A

Bronchoscopy and lavage

40
Q

what does NAAT stand for?

is this a slow or fast test?

A

Nucleic acid amplification Test

fast

41
Q

gold. S test for TB

A

sputum culture

42
Q

pt suspected of TB.

how many cough sputum must be taken?

1 of these samples must be taken at a particular time of the day, when is it?

A

3

early morning

43
Q

stain used for tuberculosis?

A

ziehl-neelsen stain

44
Q

in total how long is active TB management?

after this period what test should you do and why?

A

6 months

sputum sample, check TB is gone

45
Q

pt diagnosed with active TB.

what is the Mx?
name of drugs + duration

A

RIPE for two months
(rifampicin, isoniazid, pyrazinamide, ethambutol)

RI for 4 months.

46
Q

pt diagnosed with active TB CNS.

Mx for this patient?
- 2 features

A

antibiotics for 10 months
+
dexamethasone/prednisolone

47
Q

TB pt has large pleural effusion.

what additional drug class do you give alongside the antibiotics?

A

steroids

48
Q

are most TB pts treated as outpatient or inpatients?

A

outpatient

49
Q

what is latent nutshell MX.

- 2 options

A

3 months isoniazid (+pyridoxine) & rifampicin

OR

6 months isoniazid (+pyridoxine)

50
Q

what is pyridoxine?

A

vit B6

51
Q

why is pyridoxine given with isoniazid?

A

stop peripheral neuropathy side effects

52
Q

isoniazid:

moa?
SE?

A

stops mycolic acid synthesis

peripheral neuropathy

53
Q

rifampicin

moa?
SE?
which pt group often affected by TB are also particularly prone to the said SE?

A

inhibits bacterial DNA dependent RNA polymerase preventing DNA being transcripted into mRNA

hepatitis

HIV - (hepatits)

54
Q

Pyrazinamide

moa?
SE? (3)

A

inhibits fatty acid synthesis

hyperuricaemia (gout), arthralgia, myalgia

55
Q

inhibits the enzyme arabinosyl transferase which polymerizes arabinose into arabinan:

name of drug?
SE?

A

Ethambutol

optic neuritis

56
Q

what is a lung cavity?

colour of it on cxr?

A

a thick wall of gas in the lung

black

Respiratory (22 decks)

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