TB

• What is Mycobacterium tuberculosis?

  Aerobic, acid-fast bacilli
• How does TB mostly spread?

  Droplet infection
• What are some risk factors for TB?

  Immunosuppression

  Diabetes

  Previous lung disease

  Smoking

  Drugs/alcohol

  Malnutrition

  Poverty

  Living conditions

  Occupation
• What is the anatomical classification of TB?

  Pulmonary TB

  Extrapulmonary TB

  Miliary TB
• What does smear +ve mean in TB?

  Acid-fast bacilli are detected in sputum smear microscopy
• What does smear -ve but culture +ve mean in TB?

  No acid-fast bacilli are detected in sputum smear microscopy but culture grows Mycobacterium tuberculosis
• What are some signs and symptoms seen in general TB?

  Fever

  Weight loss

  Night sweats
• What are some signs and symptoms seen in pulmonary TB?

  Dyspnoea

  Cough

  Chest pain
• What are some signs and symptoms seen in extrapulmonary TB?

  Dependent on organ involvement
• What are the first-line investigations for TB?

  Tuberculin skin test (mantoux test)

  IGRAs

  CXR
• What are some further investigations for TB?

  Sputum smear microscopy

  Sputum culture

  NAATs

  BAL

  Tissue biopsy
• What is the treatment for active TB?

  2 phases - intensive phase -> continuation phase
• What is the intensive phase for active TB treatment?

  2 months of isoniazid + rifampin + pyrazinamide + ethambutol
• What is the continuation phase for active TB treatment?

  4 months of isoniazid + rifampin
• What is the treatment for latent TB?

  Isoniazid for 9 months OR rifampin for 4 months
• What are some side effects that may be caused by TB drugs?

  Hepatotoxicity - due to isoniazid, rifampin and pyrazinamide
• What is always given with isoniazid and why?

  Pyridoxin - prevent peripheral neuropathy
• What are some complications of TB?

  Pulmonary TB

  Miliary TB

  TB meningitis

  Skeletal TB

  Genitourinary TB

  GI TB
• How is TB infection prevented?

  BCG vaccine

  Isolate patients

  Report to local health authorities
• What are some screening tests fro TB?

  TST

  IGRA
• Who is screening for latent TB done for?

  Individuals with recent exposure

  Health care workers

  Homeless shelters and prisons

  Travellers from high-risk countries