12. TB Flashcards

1
Q

What is Tuberculosis

A

an infectious disease caused by the mycobacterium tuberculosis bacteria
it is a small rod shaped bacteria (a bacillus)
they are also resistant to the acids using in staining procedures so described as acid-fast bacilli

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2
Q

acid fast bacilli that stain red with Zeihl-Neelson stains is what organisms

A

mycobacterium tuberculosis

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3
Q

where is TB more prevalent

A

non-UK born patients (ie from South Asia)

those who are immunocompromised (ie HIV) and those with close contacts with TB

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4
Q

where is the most common site for TB infection and why

A

the lungs where they get plenty of oxygen

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5
Q

extra pulmonary TB is where it infects other areas ;

name some other areas

A
lymph nodes 'a cold abscess' is a firm painless abscess caused by TB usually in the neck 
pleura
CNS
pericardium 
GI system 
GU systemm 
cutaneous TB affecting the skin
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6
Q

what are the risk factors for TB

A
  • Known contact with active TB
  • Immigrants from areas of high TB prevalence
  • People with relatives or close contacts from countries with a high rate of TB
  • Immunosuppression due to conditions like HIV or immunosuppressant medications
  • Homeless people, drug users or alcoholics
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7
Q

What test is used prior to having the BCG vaccine

A

Mantoux test

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8
Q

what are the typical signs and symptoms of TB

A
  • Lethargy
  • Fever or night sweats
  • Weight loss
  • Cough with or without haemoptysis
  • Lymphadenopathy
  • Erythema nodosum
  • Spinal pain in spinal TB (also known as Pott’s disease of the spine)
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9
Q

what does the Mantoux test look for

A

previous immune response to TB and this indicates possible previous vaccination, latent or active TB

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10
Q

on a CXR what does primary TB look like

A

patchy consolidation, pleural effusions and hilar lymphadenopathy

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11
Q

on a CXR what does reactivated TB look like

A

patchy or nodular consolidation with cavitation (gas filled spaces in the lungs) typically in the upper zones

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12
Q

on a CXR what does disseminated biliary TB look like

A

millet seeds uniformly distributed throughout the lung fields

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13
Q

what is the management of active TB

Mnemonic RIPE

A
4 drugs 
•	R – Rifampicin for 6 months
•	I – Isoniazid for 6 months
•	P – Pyrazinamide for 2 months
•	E – Ethambutol for 2 months
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14
Q

What medication is prescribed alongside TB medications in order to prevent peripheral neuropathy caused by the isoniazid

A

pyridoxine (vitamin B6)

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15
Q

what is the main side effect of rifampicin

A

red/orange discolouration of urine and tears

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16
Q

what is the main side effect of isoniazid

A

peripheral neuropathy

vitamin B6 prescribed prophylactically

17
Q

what is the main side effect of Pyrazinamide

A

hyperuricaemia (high uric acid levels) resulting in gout

18
Q

what is the main side effect of ethambutol

A

colour blindness and reduced visual acuity