Tuberculosis Flashcards

1
Q

Definition of tuberculosis

A

Granulomatous disease caused by mycobacterium tuberculosis

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2
Q

Transmission of TB

A

Transmitted by inhalation of droplets

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3
Q

What is primary TB

A

90% - immune system localised infection to hilar lymph nodes and are eliminated or encapsulated by barrier of granulation tissue

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4
Q

What is secondary TB

A

Progression to active TB in those immunocompromised.

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5
Q

What part of the lung is TB commonly found

A

In the apex of the lung

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6
Q

What is miliary TB

A

Primary infection not contained and disseminates via bloodstream

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7
Q

Risk factors for TB

A

Ethnic minority groups, homeless, drug/alcohol abuse, close contact, immunosuppression, young or old age

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8
Q

General presentation of patient with TB

A

Subacute - chronic onset which depends on main site of infection - includes night sweats, fever, weight loss, systemic symptoms

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9
Q

What are the pulmonary features of TB

A

Chronic cough, productive of purulent sputum with or without haemoptysis. Can have bronchiectasis, pneumonia and pleural effusion

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10
Q

Most common presenting features of TB

A

Pulmonary symptoms

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11
Q

What are the CNS features of TB

A

TB meningitis or tuberculoma, headache, meningism, focal neurological signs and decreased consciousness

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12
Q

Which is the second most affected organ in TB

A

Genitourinary system

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13
Q

What are the genitourinary features of TB

A

Sterile pyuria, kidney pathology, abscesses, salpingitis, infertility and epididymo-orchitis

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14
Q

What are the MSK feature of TB

A

Arthritis, osteomyelitis, psoas abscess, Potts disease of spine

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15
Q

What are the GI features of TB

A

Abdominal pain, obstruction due to ileocaecal lesions, can spread to peritoneum

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16
Q

What are the cardiac features of TB

A

Pericardial effusions, constrictive pericarditis

17
Q

What are the cutaneous features of TB

A

Wide range of skin reactions - erythema nodusum, Bazin’s disease

18
Q

Samples and culturing in TB

A

Samples of sputum for culture and sensitivity testing. Stained with Ziehl-Neelsen or Auramine for microscopy

19
Q

Investigations into TB

A

CXR, PCR, IGRA, to test if latent or active TB, mantoux test for contacts

20
Q

First round of medical treatment of TB

A

Isoniazid, Rifampicin, Ethambutol and Pyrazinamide

21
Q

Second round of medical treatment of TB

A

Isoniazid and Rifampicin

22
Q

How long of treatment for first round of medication

A

2 months

23
Q

How long of treatment for second round of medication

A

4 months

24
Q

When is medication required for longer

A

Meningitis, pericarditis and spinal TB

25
Q

Side effects of Isoniazid

A

Peripheral neuropathy and liver toxicity

26
Q

Side effects of Rifampicin

A

Liver toxicity, hepatic enzyme inducer (P450), and red/orange bodily fluids

27
Q

Side effects of Ethambutol

A

Visual disturbances (colour blindness, loss of acuity), avoid in CKD

28
Q

Side effects of Pyrazinamide

A

Liver toxicity

29
Q

What is given to Isonazid to prevent peripheral neuropathy

A

Pyridoxine