Flashcards in TB and Pleural Infection Deck (42):
What would white on a lung CXR indicate?
Mass, fluid, lung
How could you tell the difference between TB and lobar pneumonia on a CXR?
lobar pneumonia doesn't go to the top?
Which lung problems go to top of lungs?
Airborne diseases eg. TB
What are TB granuloma walls like?
When does TB cause pulmonary disease?
if the granuloma bursts
how many people infected with TB have primary tuberculosis?
What are the clinical features of TB?
upper zone crackles
what symptoms are linked to meningeal TB?
Headache. drowsy, fits
what are symptoms of GI TB?
what are symptoms of spinal TB?
what are signs of pericardial TB?
what are symptoms of renal TB?
What are some 20th century TB tests?
ZN stain, AAFB
What test can show if a person has an inactive and active TB?
Why is PCR useful for diagnosing TB?
Can tell if it's resistant to drugs- rifampracin
What is the histology of TB like?
Multinucleate giant cell granulomas
what are key characteristics of TB in radiology?
Upper lobe predominance
scarring and shrinkage
heals with calcification
what is miliary TB?
when myobacteria gets into the bloodstream?
(also worry about renal cancer)
How do you treat TB?
Two months of: Rifampicin, Isoniazid, Pyrazinamide, Ethambutol
Then four months of: Rifampicin, Isoniazid
Who can a person TB affect?
Everyone around them!!
what are side effects of rifampicin?
Has many interactions with other drugs- eg. some contraceptive pills
What are side effects of Ethambutol?
Can cause optic neuritis
What are side effects of Isoniazid?
When would you expect to see a sudden fall in actively replicating bacilli?
2 weeks after treatment
What are types of TB drug resistance?
Single agent- Isoniazid
MDR- Rifmapicin & Isoniazid
XDR- MDR and quinolone and injectable
If a person had HIV and TB which would you likely treat first?
What is latent TB?
Balance between your organism and your immune system
(between a quarter and third of worlds population have this)
What is IGRA test?
blood test, dectecys previous exposure to TB
What is Mantoux test?
skin test, detecects previous exposure to TB and BCG
Which test would be used for mass contact tracing?
how do you manage latent TB?
Treat or leave alone
6 months isoniazid or 3 months rifampicin and isoniazid
What increases risk of latent TB reactivation?
steroids/ immunosuppressant drugs
How to stop spread of TB?
screening of high risk groups
isolation of infectious causes
What test should all TB patients be offered?
What should all patients with HIV be offered?
What does 'smear positive' indicate?
what is a d-shape on CXR associated with?
who is at risk of pleural infection?
IV drug abuse
what are different types of pleural infection?
Simple parapneumponic effusion
complicated parapneumonic effusion
what Pleural infection is pussy?
How do you manage pleural infection?
Drain effusion as needed
early discussion with surgeons if persistent sepsis
nutrition (albumin levels)