12.) Pulmonary TB And AIDS

Question 1

Define

Answer 1

Pulmonary tuberculosis is a bacterial infection caused by mycobacterium tuberculosis primarily affecting the lungs

Question 2

Pathogenesis

Answer 2

After inhalation, TB reaches of your lungs and is ingested by macrophages they multiply and spread to lymph nodes after 2 to 4 weeks we have a delayed hypersensitivity reaction causing tissue damage and granuloma

Question 3

Symptoms

Answer 3

Cough , fever , night sweats, hemoptysis chest pain

Question 4

Diagnosis

Answer 4

Sputum examination: Using acid fast bacilli staining

Culture : in the lowenstein jansen media

✅ Tuberculin Skin Test (TST):
Inject PPD under the skin, then check after 48–72 hours.
If the bump (induration) is ≥5–15 mm, it’s positive, depending on risk group.

⸻

✅ Interferon Gamma Release Assay (IGRA):
A blood test that checks if T-cells release interferon-gamma when exposed to TB proteins — indicates TB infection, more specific than TST.

Question 5

Any symptoms in Latent stages ?

Answer 5

No only in active stage

Question 6

Treatment

Answer 6

Initial 2 months

Isoniazid : 5mg/kg up to 300mg oral once daily

Rifampicin : 10mg/kg up to 600mg oral once daily

Pyrazinamide : 25-30 mg/kg up to 2g oral once daily

Ethambutol : 15-20 mg/kg up to 1.2g once daily

Continuation 4 months
Izoniazid 5mg/kg
Rifampicin 10mg/kg

Question 7

Drug side effects

Answer 7

✅ Rifampicin:
• Orange-colored urine
• Hepatotoxicity

✅ Isoniazid (INH):
• Hepatotoxicity
• Peripheral neuropathy

✅ Pyrazinamide:
• Hyperuricemia (gout)
• Hepatotoxicity

✅ Ethambutol:
• Optic neuritis (vision changes)
• Red-green color blindness