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Flashcards in TB and Pleural Infection Deck (42):
1

What would white on a lung CXR indicate?

Mass, fluid, lung

2

How could you tell the difference between TB and lobar pneumonia on a CXR?

lobar pneumonia doesn't go to the top?

3

Which lung problems go to top of lungs?

Airborne diseases eg. TB

4

What are TB granuloma walls like?

Thickened

5

When does TB cause pulmonary disease?

if the granuloma bursts

6

how many people infected with TB have primary tuberculosis?

5%

7

What are the clinical features of TB?

weight loss
malaise
night sweats
cough
heamoptysis
breathlessness
upper zone crackles

8

what symptoms are linked to meningeal TB?

Headache. drowsy, fits

9

what are symptoms of GI TB?

Pain
bowel obstruction
perforation
perironitis

10

what are symptoms of spinal TB?

Pain
deformity
paraplegia

11

what are signs of pericardial TB?

tamponade

12

what are symptoms of renal TB?

renal failure

13

What are some 20th century TB tests?

ZN stain, AAFB
auramine

14

What test can show if a person has an inactive and active TB?

PCR

15

Why is PCR useful for diagnosing TB?

Can tell if it's resistant to drugs- rifampracin

16

What is the histology of TB like?

Multinucleate giant cell granulomas
caseating necrosis
visible mycobacteria

17

what are key characteristics of TB in radiology?

Upper lobe predominance
cavity formation
tissue destruction
scarring and shrinkage
heals with calcification

18

what is miliary TB?

when myobacteria gets into the bloodstream?

(also worry about renal cancer)

19

How do you treat TB?

Two months of: Rifampicin, Isoniazid, Pyrazinamide, Ethambutol

Then four months of: Rifampicin, Isoniazid

20

Who can a person TB affect?

Everyone around them!!

21

what are side effects of rifampicin?

Colours urine
Has many interactions with other drugs- eg. some contraceptive pills

22

What are side effects of Ethambutol?

Can cause optic neuritis

23

What are side effects of Isoniazid?

B-6 neuropathy

24

When would you expect to see a sudden fall in actively replicating bacilli?

2 weeks after treatment

25

What are types of TB drug resistance?

Single agent- Isoniazid
MDR- Rifmapicin & Isoniazid
XDR- MDR and quinolone and injectable

26

If a person had HIV and TB which would you likely treat first?

HIV

27

What is latent TB?

symptom free
culture negative
Balance between your organism and your immune system
(between a quarter and third of worlds population have this)

28

What is IGRA test?

blood test, dectecys previous exposure to TB

29

What is Mantoux test?

skin test, detecects previous exposure to TB and BCG

30

Which test would be used for mass contact tracing?

IGRA

31

how do you manage latent TB?

Treat or leave alone
anti-TNF drugs:
6 months isoniazid or 3 months rifampicin and isoniazid

32

What increases risk of latent TB reactivation?

rheumatoid arthritis
TNFi
steroids/ immunosuppressant drugs

33

How to stop spread of TB?

Contact tracing
screening of high risk groups
isolation of infectious causes
BCG immunisation
social measures

34

What test should all TB patients be offered?

HIV

35

What should all patients with HIV be offered?

Chest X-ray

36

What does 'smear positive' indicate?

active TB

37

what is a d-shape on CXR associated with?

empyema

38

who is at risk of pleural infection?

Diabetes
immunosuppression
gastro-oesophageal reflux
alcohol missuse
IV drug abuse

39

what are different types of pleural infection?

Simple parapneumponic effusion
complicated parapneumonic effusion
empyema

40

what Pleural infection is pussy?

Empyema

41

How do you manage pleural infection?

Antibiotics
Drain effusion as needed
early discussion with surgeons if persistent sepsis
nutrition (albumin levels)
VTE prophylaxis

42

which antibiotic is good for reaching the pleural space?

Vancamicin