Tuberculosis Flashcards Preview

Respiratory Diseases > Tuberculosis > Flashcards

Flashcards in Tuberculosis Deck (21):
1

what is it

infectious disease of resp tract
type 4 hypersensitivity - caseating granulomas and caseous necrosis

2

what happens during primary exposure (1st time)

affects hilar lymph nodes
granulomatous due to immune activation

3

what happens during secondary exposure (2nd time)

fibrosing and cavitating apical lesions due to overactive T cell response
this is the reactivation of latent TB

4

what are causes

mycobacterium tuberculin
m. bovis

5

what are resp symptoms

cough
haemoptysis
upper lobe crackles
dyspnoea

6

what are GI symptoms

peritonitis
perforation
bowel obstruction
pain

7

what are spinal symptoms

pain
deformity
paraplegia

8

what are meningeal symptoms

drowsy
headache
fits

9

what are other symptoms

renal failure
weight loss
night sweats
lymphodenopathy and cold abscess
pericardial temponade
septic athritis and hypoadrenalism

10

how is it diagnosed

CXR and ZN stain of sputum for acid and alcohol fast bacilli

11

what does CXR look like

upper lobe prominance, cavity formation, tissue destruction, scarring and shrinkage, heals with calcification

12

when does the CXR contain bilateral infiltrates and reticulonodular shadowing

presence of ARDS/miliary TB - result of tubercle bacilli in blood stream

13

what is treatment

2 months RIPE (rifampicin, isoniazid, pyradizamide and ethambutol)
4 months RI

14

what is side effect of rifampicin

stains fluids pink/orange
break opiate and steroids (the pill)
rarely hepatitis

15

what is side effect of isoniazid

polyneuropathy

16

what is side effect of pyradizamide

hepatic toxicity, reduces renal excretion of urate and may precipitate gout

17

what is side effect of ethambutol

optic neuritis, red/green colour blindness

18

how can it be prevented

BCG vaccine - reduces risk by 70%
contact tracing

19

what is latent TB

symptom free, granulomas, -ve cultures, leave alone

20

what reactivates latent TB

steroids, immunosuppression and anti-TNF

21

what is anti-TNF

used to treat rheumatoid athritis, crohns, psoriasis, alkylasing spondylitis
if have latent TB - give 6 months of I or 3 months of RI before starting anti-TNF