UH Resp Diseases III

• What is the disease caused by Mycobacterium tuberculosis complex?

  Tuberculosis (TB)
• What bacterium primarily causes tuberculosis?

  Mycobacterium tuberculosis complex
• Which organ does tuberculosis primarily affect?

  The lungs

  
• Can tuberculosis affect organs other than the lungs?

  Yes, it can involve any organ.
• What type of disease is tuberculosis (TB)?

  Granulomatous disease
• How is tuberculosis transmitted?

  Through droplet inhalation
• What is a common way tuberculosis is spread?

  By coughing and sneezing
• What happens in most cases of tuberculosis infection?

  Immediate clearance of the bacteria
• What is primary active tuberculosis?

  Active infection after exposure
• What characterizes latent tuberculosis?

  Presence of the bacteria without being symptomatic or contagious
• What is secondary tuberculosis?

  Reactivation of latent tuberculosis to active infection
• What is the most common site for TB infection?

  The lungs

  
• Why is the lung a common site for TB infection?

  Because it gets plenty of oxygen
• What does extrapulmonary tuberculosis refer to?

  • Disease in areas other than the lungs
  • Common sites include:
  • Lymph nodes
  • Pleura
  • Central nervous system
  • Pericardium
  • Gastrointestinal system
  • Genitourinary system
  • Bones and joints
  • Skin (cutaneous tuberculosis)

  
• What are some risk factors for tuberculosis?

  Close contact with an infected person, demographic factors, and medical conditions
• Which medical condition is a risk factor for tuberculosis?

  HIV immunosuppression
• What are general symptoms of tuberculosis?

  Fever, lethargy, anorexia, weight loss
• What are pulmonary symptoms of tuberculosis?

  Chronic cough, sputum, breathlessness, chest pain

  
• What are extrapulmonary symptoms of tuberculosis?

  Urinary symptoms, joint pain, headache, chest pain, abdominal pain, rash

  
• What percentage of TB cases in the UK are pulmonary?

  60%
• Why is a respiratory examination essential when suspecting TB?

  Because 60% of TB cases are pulmonary
• What are typical clinical findings on respiratory examination for tuberculosis?

  • Sputum pots with purulent or blood-stained sputum
  • Enlarged, tender lymph nodes
  • Crackles or bronchial breathing over consolidation
  • Dullness to percussion and decreased fremitus over pleural effusions
  • Chest X-ray showing patchy opacification of pulmonary TB
• What are some investigations for tuberculosis?

  ECG, blood tests, sputum microscopy/culture, chest X-ray, CT chest, Mantoux Test
• What does the Mantoux test involve?

  Injecting tuberculin into the intradermal space on the forearm
• How is the Mantoux test read?

  By measuring the induration of the skin at the injection site after 72 hours
• What is considered a positive result in the Mantoux test?

  An induration of 5mm or more
• What does IGRA stand for?

  Interferon-Gamma Release Assay
• What is the purpose of the IGRA test?

  To detect sensitized white blood cells releasing interferon-gamma
• What characteristic appearance does disseminated miliary tuberculosis give on a chest X-ray?

  “Millet seeds” appearance with small nodules
• From what can miliary TB develop?

  From primary progressive or post-primary TB
• What mnemonic can help remember the treatment for active tuberculosis?

  RIPE
• What does the RIPE mnemonic stand for in tuberculosis treatment?

  • R – Rifampicin for 6 months
  • I – Isoniazid for 6 months
  • P – Pyrazinamide for 2 months
  • E – Ethambutol for 2 months
• What should be monitored during tuberculosis treatment?

  Liver function and visual acuity
• What side effect is associated with Isoniazid?

  Peripheral neuropathy
• What is co-prescribed with Isoniazid to prevent peripheral neuropathy?

  Pyridoxine (Vitamin B6)
• How is latent tuberculosis treated?

  With Isoniazid and rifampicin or Isoniazid for 6 months
• What are other management options for tuberculosis?

  • Testing for other infectious diseases (e.g., HIV, hepatitis B and C)
  • Testing contacts for tuberculosis
  • Notifying Public Health England of suspected cases
  • Isolating patients with active tuberculosis to prevent spread (usually for at least 2 weeks of treatment)
  • A specialist MDT guides management and follow-up
• What type of tuberculosis requires individualized regimes?

  Multidrug-resistant tuberculosis and extrapulmonary disease
• What is the purpose of negative pressure rooms in hospitals?

  To prevent airborne spread of tuberculosis
• What does the BCG vaccine provide immunity against?

  1. tuberculosis