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GENERAL MEDICINE > TB > Flashcards

TB Flashcards

1
Q

What is Ghon focus

A

Primary lesion characterized by aggregation of numerous granulomas in periphery of lung

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2
Q

What is ghon complex

A

Combination of calcified ghon focus with lymph node involvement

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3
Q

What is Rankes complex

A

When ghon complex undergoes fibrosis in calcification

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4
Q

What are the symptoms of primary TB

A
  1. Influenza like illness
  2. lymphadenopathy
  3. collapse of lungs
  4. consolidation of lungs
  5. cavitation
  6. Miliary TB
  7. meningitis
  8. pericarditis
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5
Q

What is the difference between primary and secondary TB

A

Secondary TB occurs when the hosts immunity is weakened

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6
Q

What are the clinical features of secondary TB

A
  1. Affects mostly oxygenated parts of lungs
  2. chronic cough with haemoptysis
  3. low-grade fever, night sweats, weight loss, malaise, loss of appetite
  4. spontaneous pneumothorax
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7
Q

What does miliary TB mean

A

It is a result of acute diffuse dissemination of tubercle Bacilli via the bloodstream

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8
Q

What clinical features are specific to miliary TB

A
  1. Hepatosplenomegaly
  2. dry cough
  3. headache which may indicate a coexisting meningitis
  4. funduscopy will choroidal tubercles
  5. chest x-ray will show millet seed appearance 1-2 mm lesions
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9
Q

What are the complications of pulmonary TB

A
  1. Aspergergilloma
  2. Massive haemoptysis
  3. cor pulmonale 
  4. Bronchiectasis
  5. bronchopleural fistula
  6. non-pulmonary: Enteritis, anorectal disease, poncets polyarthritis
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10
Q

What Are the Clinical features of lymph nodes in TB

A
  1. Painless lymphadenopathy
  2. Initially nodes are mobile
  3. Nodes later become matted and can Suppurate with sinus formation
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11
Q

What are the clinical features of G.I. disease in TB

A
  1. Right iliac fossa mass
  2. acute abdomen 
  3. tuberculosis peritonitis
  4. ascites
  5. abdominal distension
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12
Q

What are the clinical features of pericardial disease in TB 

A
  1. Breathlessness and abdominal swelling
  2. fever and night sweats
  3. Raised JVP
  4. hepatospleenomegaly
  5. prominent ascites
  6. peripheral edema
  7. chest x-ray shows increased pericardial dulness and globular enlarged heart in pericardial effusion
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13
Q

What is the Important sign in pericardial disease in TB

A

Early third heart sound and pericardial calcification

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14
Q

What are the diseases of CNS associated with TB

A
  1. Meningitis
  2. Tuberculoma
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15
Q

What are the bone and joint diseases related to TB

A
  1. Poncets arthropathy
  2. Potts disease 
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16
Q

What are the investigations used to diagnose TB

A
  1. Chest x-ray
  2. Sputum staining
  3. sputum culture
  4. tests for extra pulmonary TB
  5.  Mantoux teat
  6. Pleural fluid culture
  7. Bronchial washing
  8. Biopsy
  9. PCR
  10. Interferon gamma release assay (IGRA)
  11. Adenosine deaminase (ADA)
17
Q

What are the tests for extra pulmonary TB

A
  1. Fluid examination
  2. tissue biopsy
  3. bone marrow biopsy
  4. liver biopsy
18
Q

What are the drugs used to treat tuberculosis

A
  1. Isoniazid
  2. rifampicin
  3. Pyrazinamide
  4. Ethambutol
19
Q

What is the regime of treatment for tuberculosis

A
  1. Initial phase - 2 months: isoniazid, rifampicin, pyrazinamide, ethambutol
  2. Continuation phase – 4 months isoniazid and rifampicin
20
Q

In which conditions is treatment of tuberculosis extended for 9 to 12 months

A
  1. HIV positive
  2. tuberculous osteomyelitis
  3. miliary tuberculosis
  4. meningitis
  5. pregnancy
  6. drug intolerance
21
Q

Isoniazid should always be started with which drug to prevent symptoms of deficiency

A

Pyridoxine vitamin B6

22
Q

Which drug can cause orange to red colouration of the body secretions

A

rifampicin

23
Q

What are the side effects of Ethambutol

A

Optic neuritis which is colour blindness for green, decreased visual equity, central scotoma

24
Q

Which drug may cause gout

A

Pyrazinamide 

25
Q

Which drug may cause vestibular nerve damage

A

Streptomycin

26
Q

What are the second line drugs for tuberculosis

A
  1. Quinolones
  2. amikacin
  3. Kanamycin, Capteomycin
  4. cyclocerine 
27
Q

What are the indications of use of steroids in tuberculosis

A
  1. Pericardial disease
  2. tuberculosis meningitis
  3. Genitourinary TB
  4. Miliary TB
  5. Acutely ill patient
  6. Widespread infiltration
  7. Large lymph nodes compressing trachea or bronchi
28
Q

What are the drugs used for extensive drug-resistant TB

A
  1. Kanamycin
  2. Capteomycin
  3. amikacin 
29
Q

Which test is used for assessment of asymptomatic TB patients

A

PPD testing (mantoux test)

30
Q

Pleural fluid DR shows what characteristics of exudate

A
  1. pH less than 7.2
  2. protein concentration more than 50% of that of serum
  3. WBC 500 to 2500 mainly lymphocytes

GENERAL MEDICINE (9 decks)

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