Tuberculosis Flashcards

(41 cards)

1
Q

What is Tuberculosis?

A
  • Infection with Mycobacterium tuberculosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What sort of inflammation occurs in TB?

A

Caseating granulomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where in the world is higher risk of TB?

A
  • Asia
  • African
  • Latin America

TRAVEL Hx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is primary TB?

A

First infection of TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does primary TB create in the lung?

A

Gohn’s Focus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the name of a Gohn’s Focus in a lymph node?

A

Gohn’s complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is secondary TB?

A

Reactivated TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Where does secondary TB most commonly occur?

A

Lung apex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What type of hypersensitivity is secondary TB?

A

Type 4 (cell-mediated)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is latent TB?

A

Inactive TB (asymptomatic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is miliary TB?

A

TB that is disseminated through the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does miliary TB spread?

A

Lymphohaematogenous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Who is at risk of miliary TB?

A
  • IVDUs
  • HIV
  • Malnutrition
  • Steroid users
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What symptoms does TB present with?

A
  • Pleuritic chest pain
  • Low-grade fever
  • Cough (dry at first and then productive)
  • Haemoptysis
  • Weight loss
  • Night sweats
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the red flags of TB?

A
  • Night sweats

- Weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is cutaneous TB?

A

TB in the skin, most commonly affecting previously sensitised patients who have high immunity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How does cutaneous TB present?

A

Skin erythema, normally well demarcated but non-specific

18
Q

What is erythema nodosum?

A
  • Inflammation of subcutaneous fat

- Causes pre-tibial marking- pale erythema/bruising

19
Q

How would you stain TB?

A
  • Ziehl Nielson (ZN) stain
20
Q

Why can’t TB be stained with H&E?

A

TB is acid fast, and wouldn’t show on a normal stain

21
Q

What other blood test can be used for TB?

A

Interferon gamma release assay

22
Q

What would a CXR show for TB?

A
  • Fibronodular opacities +/- cavitation

- A-E (second card)

23
Q

What is the A-E of a TB CXR?

A
Alveolar shadowing (batwing)
Kerley B lines
Cardiomegaly
Distribution of vessels to the apices
Effusion
24
Q

What is a Mantoux test?

A

Tuberculin sensitivity to see latent disease

25
How long do you wait for a Mantoux result?
2-3 days
26
How will vaccinated person show on Mantoux?
6-15mm raised bump
27
How will latent TB show on Mantoux?
15mm+
28
What MUST you do on diagnosis?
Notify local health team/infectious diseases officer within 3 days
29
What five drugs are used for TB?
RIPE - Rifampicin - Isoniazid and Pyridoxine (B6) - Pyrazinamide - Ethambutol
30
How long are [R,I+p] used for?
6 months
31
How long are [P,E] used for?
Three months
32
What are the side effects of R?
OI - Orange urine and tears - Induces Cyp450 enzymes
33
What are the side effects of I?
HIPA - Hepatitis - Inhibits Cyp450 enzymes - Peripheral neuropathy (hence given with B6) - Agranulocytosis
34
Why give pyridoxine with isoniazid?
To prevent peripheral neuropathy
35
What is agranulocytosis?
Drop in inflammatory cells, particularly neutrophils
36
What do you do if you suspect INH-induced agranulocytosis?
- Admit | - Stop Isoniazid
37
What are the side effects of pyrazinamide?
HMG - Hepatitis - Muscle/joint pain - Gout (hyperuricaemia)
38
What is the side effect of Ethambutol?
Optic neuritis
39
What should you do before beginning ethambutol?
Visual acuity test (to reference and monitor for optic neuritis)
40
Name three complications of TB.
- Pott’s disease - Pneumothorax - Bronchiectasis
41
What is Pott’s disease and how does it occur?
- TB of the spine | - Haematogenous spread of TB