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Tuberculosis Flashcards

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1
Q

bacteria that causes tuberculosis?

A

mycobacterium tuberculosis

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2
Q

why is mycobacterium tuberculosis protected from macrophages?

A

mycolic acid capsule

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3
Q

why must body form granuloma to section off TB, i.e. why can the macrophages just not kill the mycobacterium tuberculosis?

A

mycolic acid capsule

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4
Q

main transmission for mycobacterium tuberculosis ?

A

droplets

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5
Q

how does mycobacterium tuberculosis travel through the body systemically?

A

lymph (nodes)

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6
Q

4 statuses of TB infection, and define each.

A

primary - you first get it but contain via granuloma

latent - infection now harboured and you are asymptomatic

secondary - latent activates, happens in immunocompromised

miliary -spreads systemically

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7
Q

how many people have latent TB worldwide?

A

1.7 billion

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8
Q

Where globally is TB the most prevalent?

- 2 places

A

South Asia + Sub-Sahara Africa

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9
Q

can TB effect other organs aside the lungs?

A

yes

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10
Q

purpose of forming granuloma?

A

section off the TB so it can not spread

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11
Q

what does granuloma contain?

A

tubercle laden macrophages

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12
Q

% wise how many immunocompetent will successfully form granuloma to section off TB.

A

90%

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13
Q

risk factors for TB infection?

- 6

A

Homelessness
Alcohol/drugs/smoking
Immunocompromised: HIV, steroids use, malnutrition.
Silicosis: impairs macrophage

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14
Q

are people who get primary TB will usually asymptomatic.

A

yes, usually asymptomatic.

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15
Q

most serious complication of TB?

A

TB meningitis

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16
Q

someone has TB with cavity.

if cavity ruptures what complication will they now get?

A

pneumothorax

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17
Q

why is right middle lobe syndrome a complication of TB?

A

big hilar lymph nodes crush the R middle lobe

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18
Q

a latent TB reactivates in an immunocompromised person.

what type of TB is this called now.

A

secondary active TB

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19
Q

screening test for TB?

A

mantoux test

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20
Q

what is injected in the classic screening test for TB?

-name, how much, where, route

A

0.1ml PPD Tuberculin
arm
intradermally

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21
Q

on doing mantoux test how long do you wait before measuring the swelling?

A

48 hours

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22
Q

pt has mantoux test

swelling is <5mm.

interpretation?

A

negative

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23
Q

pt has mantoux test

swelling is 5-14mm.

24
Q

pt has mantoux test

swelling is >14mm.

Study These Flashcards
A

strongly positive

25
HIV pt has mantoux test swelling is 3mm. is this is a negative result?
no because pt has HIV/
26
a granuloma calcifies to form what? and when this thing combines with hilar lymph nodes, what is it called then?
ghon lesion ghon complex
27
vaccine for TB and leprosy?
BCG
28
4 people in which the BCG vaccine is contraindicated?
HIV history of TB, +ve Mantoux text >35 years old
29
3 people who should get BCG vaccine?
prisoners healthcare workers homeless
30
typical systemic symptoms for TB, (common for lots of infections)? -4
Fever weight loss night sweats lymphadenopathy
31
symptoms of TB? | - 8
``` Haemoptysis Dyspnoea Cough with mucus Chest pain fever weight loss night sweats lymphadenopathy ```
32
TB causes a cough. is there or is there not mucus with the cough?
mucus is present
33
TB causes haemoptysis. typically is it small bleeding or lots of bleeding?
small amounts of blood
34
auscultating on someone with TB, what may heard (sometimes)? -1
crackles
35
you examine someone with TB. what sign may be present for someone with long-standing TB
clubbing
36
is CXR diagnostic for TB?
no
37
is sputum culture diagnostic for TB?
yes
38
CXR finding for someone with TB? - 3 things
upper zone cavities consolidation big hilar
39
pt can not tolerate sputum sample. what is 2nd line Ix that can be done instead?
Bronchoscopy and lavage
40
what does NAAT stand for? is this a slow or fast test?
Nucleic acid amplification Test fast
41
gold. S test for TB
sputum culture
42
pt suspected of TB. how many cough sputum must be taken? 1 of these samples must be taken at a particular time of the day, when is it?
3 early morning
43
stain used for tuberculosis?
ziehl-neelsen stain
44
in total how long is active TB management? after this period what test should you do and why?
6 months sputum sample, check TB is gone
45
pt diagnosed with active TB. what is the Mx? name of drugs + duration
RIPE for two months (rifampicin, isoniazid, pyrazinamide, ethambutol) RI for 4 months.
46
pt diagnosed with active TB CNS. Mx for this patient? - 2 features
antibiotics for 10 months + dexamethasone/prednisolone
47
TB pt has large pleural effusion. what additional drug class do you give alongside the antibiotics?
steroids
48
are most TB pts treated as outpatient or inpatients?
outpatient
49
what is latent nutshell MX. | - 2 options
3 months isoniazid (+pyridoxine) & rifampicin OR 6 months isoniazid (+pyridoxine)
50
what is pyridoxine?
vit B6
51
why is pyridoxine given with isoniazid?
stop peripheral neuropathy side effects
52
isoniazid: moa? SE?
stops mycolic acid synthesis peripheral neuropathy
53
rifampicin moa? SE? which pt group often affected by TB are also particularly prone to the said SE?
inhibits bacterial DNA dependent RNA polymerase preventing DNA being transcripted into mRNA hepatitis HIV - (hepatits)
54
Pyrazinamide moa? SE? (3)
inhibits fatty acid synthesis hyperuricaemia (gout), arthralgia, myalgia
55
inhibits the enzyme arabinosyl transferase which polymerizes arabinose into arabinan: name of drug? SE?
Ethambutol | optic neuritis
56
what is a lung cavity? colour of it on cxr?
a thick wall of gas in the lung black

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