Tuberculosis (Koch's disease)

Question 1

Pulmonary tuberculosis is spread by?

Answer 1

Pulmonary tuberculosis is spread by droplet infection (coughing, sneezing etc) due to Mycobacterium tuberculosis.

Question 2

is Mycobacterium tuberculosis aerobic or anaerobic

Answer 2

Strict aerobic bacteria

Question 3

Why mycobacterium described by acid fast bacillus

Answer 3

Described as acidfast bacillius because Has mycolic acid in its cell wall( therefore able to resist decolourisation by a treatment with a mixture of acid and alcohol. during staining )

Question 4

The reservoir for TB is ?

Answer 4

Human being with active tuberculosis

Question 5

why M. tuberculosis different disease

Answer 5

Infection with M. tuberculosis is different from disease. Infection is the presence of organisms, which
*
may or may not cause clinically significant disease.

Question 6

—————is asymptomatic though it may be associated with fever and pleural effusion.

Answer 6

Primary tuberculosis

Question 7

Infection with M.tuberculosis leads to the developnent of which hypersensitivity? and may be treated with what?

Answer 7

Infection with M. tuberculosis typically leads to the development of delayed hypersensitivity to M. tuberculosis antigens, which can be detected by the tuberculin (Mantoux) test.

Question 8

A positive tuberculin test reslts signifies of what?

Answer 8

A positive tuberculin test result signifies cell mediated hypersensitivity to tubercular antigens but does not differentiate between infection and disease

Question 9

which stain is used for acid fast bacilli

Answer 9

Ziehl neelsen stain

Question 10

The Ziehl neelsen stain is used to identify?

Answer 10

Ziehl neelsen stain is used to identify mycobacteria in a tissuesThese organisms stain as red rods (), seen here at high magnification.

Question 11

What does large amount of mycolic acids impart

Answer 11

The large amount of mycolic acid imparts this acid-fast property to the mycobacteria and also accounts for their resistance to immune cell destruction.

Question 12

The destruction of acid-fast bacilli depends upon what?

Answer 12

Their destruction depends upon a subtype 1 helper T-cell (TH1) immune response with CD4 cell elaboration of interferon-γ that recruits monocytes and transforms them into epithelioid macrophages, then stimulates upregulation of nitric oxide synthase within epithelioid cell and giant-cell phagosomes.

Question 13

What does the PCR does in pulmonary infetions acid-fast bacilli

Answer 13

PCR analysis of respiratory specimens provides greater sensitivity and specificity for detection ofMycobacterium tuberculosisthan microscopy

Question 14

Name the tuberculosis that develops in a previously unexposed and unsensitized individual

Answer 14

Primary tuberculosis

Question 15

The sources of primary tuberculosis is usually endogenuous or exogenous?

Answer 15

exogenous

Question 16

Primary tuberculosis usually develops in the?

Answer 16

Lungs

Question 17

Most patient with tuberculosis develops latent disease while a minority develops what?

Answer 17

Progressive infection

Question 18

Typically the inhaled bacilli implant in the ?

Answer 18

distal airspaces of the lower part of the upper lobe or the upper part of the lower lobe due to most of the inspired air being distributed here and form a subpleural lesion.

Question 19

What is Ghon’s complex

Answer 19

subpleural lesion +draining lymphatics + lymph nodes is called as Ghon’s complex

Question 20

Histologically apperance or primary tuberculosis

Answer 20

Histologically
The sites of active disease show a characteristic granulomatous inflammatory reaction having the
presence of both caseating and non-caseating tubercles. There is also presence of Langhans giant
cells and lymphocytes

Question 21

During first few weeks, what is witnessed in the other part of the body?

Answer 21

During the first few weeks, there is also lymphatic and hematogenous dissemination to other parts of the body.

Question 22

Explain the simon focus

Answer 22

At times, occult hematogenous spread occurs in primary TB where the focus is then called Simon focus

Question 23

In majority of period which immunity controls infection in the primary tuberculosis

Answer 23

In majority of the people, development of cell-mediated immunity controls the infection

Question 24

The Ghon’s complex undergoes what?

Answer 24

Progressive fibrosis and calcification

Question 25

Pattern of disease arises in a previously sensitized host

Answer 25

Secondary tuberculosis

Question 26

The secondary tuberculosis results to reactivation of what?

Answer 26

Results from a reactivation of latent primary lesions after many years of an initial infection, particularly when host immunity is decreased or uncommonly may follow primary tuberculosis.

Question 27

Secondaey pulmonary tuberculosis is localised where?

Answer 27

Secondary pulmonary tuberculosis is classically localized to the apex of the upper lobes of the lungs called as Puhl lesion.

Question 28

explain the difference between right and left lung in secondary infection

Answer 28

The right lung is affected more commonly as compared to left because of high oxygen tension in the apices.

Question 29

what is assman focus

Answer 29

Infraclavicular lesion of chronic pulmonary TB is called assman focus.

Question 30

In secondary tuberculosis the preexistance of hypersensitivity controbutes to what?

Answer 30

The preexistence of hypersensitivity contributes to an immediate and marked tissue response leading to localization of the infection (the regional lymph nodes are less prominently involved in secondary tuberculosis) and cavitation followed by erosion into an airway (leading to spread of bacilli during coughing).

Question 31

Histologically appearance of secondary tuberculosis

Answer 31

Histologically, the active lesions show characteristic coalescent tubercles composed of epithelioid cells and langhans cells with central caseation.

Question 32

FILL IN THE MISSING WORDS Progressive ------------ tuberculosis It is seen in the ------------------ and the immunosuppressed individuals. The -----------lesion enlarges with increase in the area of --------------------. The erosion of blood vessels (particularly bronchial arteryQ) results in ---------------. The pleural cavity is associated with --------- or -----------. If the treatment is adequate, the disease may be ----------- but if it is inadequate, the infection may ----------- through airways, lymphatics or the vascular system

Answer 32

Progressive ** pulmonary** tuberculosis It is seen in the **elderly ** and the immunosuppressed individuals. The **apical** lesion enlarges with increase in the area of **caseation**. The erosion of blood vessels (particularly bronchial arteryQ) results in **hemoptysis**. The pleural cavity is associated with **pleural effusion or empyema.** If the treatment is adequate, the disease may be **controlled **but if it is inadequate, the infection may **disseminate** through airways, lymphatics or the vascular system