Tuberculosis and Fungal Pulmonary Disease Flashcards Preview

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Flashcards in Tuberculosis and Fungal Pulmonary Disease Deck (13):
1

Commonalities

Most are subclinical or asymptomatic

Often granulomatous (CMI)

Less acute and striiking than bacterial

Protracted with out tx

Might have consitutuonal but might not

Chest exam is unremarkable oftne

2

Tb hx, exam,

Cough, weight loss, fever and nightsweat (not in elderly)

Evidence of chronic illness, lungs clear, findings of pleural effusion

Adnopathy?

3

How to read PPD

Normal - 15
High risk - 10
HIV, close contact - 5

4

Miliary vs other

Lung biopsy best for miliary

Gastric aspiration if unccoperative and producing sputum

If bronchial, then can collect sputum

5

Sputum stidues

Negative smears are more common without cavities (HIV)

POsitive smear needs high volume of bacilli

6

MAC

Mycobacterium avium-intracellulare

Non-communicbe

Wait for result

Non-smoker

Classic - older men with COPD...sputum and chornic fibrocavitary opaciticis...smear is positive (mimics usual TB)

Lady Windermemes - more in women, non smokers, chronic dry cough...nodules and bronchiectasis favoring right middle lobe and mser often negative

7

Caseating granulomas

Seen in TB and histo very often...GPA can also cause

Othere endemic fungi and atypical TB produce NON-caseating granulomas...along with sarcoidosis, berylliosis, and HS penumonitis

8

Histo

Hilar and mediastinal lymphadenopathy (different than blasto)

Similarto primary TB in this case

9

Pulomnary blastomycosis

Extrapulmonary dz result of dissemination

Air-space opacities, cavities, mass-like and milirary opacitis WITHOUT adenopathy

Granuloma with prom neutrophils

Tx with itraconazloe

10

PJP

Drug of choice is bactrim in immunocompromised

Pneumothorax

11

Hyphae

Look for the crescent sign (indicates tissue infarction)

Neutropenia

12

Blasto vs. candida

Pneumo

Path

Blasto is stronger than candida...both have true yeast forms

Pneumo - disc-shaped cyst with intracystic bodies

13

Coccidiomycosis unique

Eosinophila

SW US

Valley Fever