Tuberculosis [96] Flashcards Preview

A - MSRA Paediatrics [15] > Tuberculosis [96] > Flashcards

Flashcards in Tuberculosis [96] Deck (22)
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1
Q

What is tuberculosis?

A

An infectious disease usually caused by Mycobacterium Tuberculosis

2
Q

Where does TB affect?

A

Generally affects lungs, but can also affect other parts of the body

3
Q

How is M. TB spread from person to person?

A

Droplet infection

4
Q

What happens to M. TB once inhaled?

A

Some bacilli remain at the site of entry, and the rest are carried to regional lymph nodes

5
Q

What happens to the bacilli at the site of entry and regional lymph nodes in TB?

A

The bacilli multiply at both sites, with both sites collectively being referred to as the primary focus

6
Q

What can happen after bacilli have divided at the primary focus in TB?

A

They can spread via the blood and lymphatics

7
Q

What are the risk factors for TB?

A
  • Close proximity to others infected
  • Underlying immunodeficiency
  • Living in endemic areas
8
Q

What % of infants with TB have minimal or no symptoms?

A

Nearly half

9
Q

What % of children with TB have minimal or no symptoms?

A

90%

10
Q

Why do a lot of infants/children with TB have no symptoms or signs of infection?

A

Because a local inflammatory reaction limits the progression of the infection

11
Q

What happens if the local host response fails to contain the inhaled TB?

A

The immune system will respond to the infection 3-6 weeks later

12
Q

What symptoms occur 3-6 weeks after infection with TB if the immune system cannot contain the inhaled TB?

A
  • Fever
  • Anorexia and weight loss
  • Cough
13
Q

What additional problems may arise due to the inflammatory reaction in TB?

A

May cause bronchial obstruction with collapse and consolidation of the affected lung, and plural effusions

14
Q

What kind of TB infections can become dormant?

A

Both symptomatic and asymptomatic

15
Q

What can happen to latent TB infections?

A

They can subsequently become reactive and spread by lymphohaematological routes

16
Q

How might reactivation of TB present?

A

May present as localised disease, or be widely disseminated to sites such as bones, joints, kidneys, pericardium, and CNS

17
Q

What investigations can be done in TB?

A
  • TB skin test
  • CXR
  • Sputum testing
  • Interferon-gamma release assays
18
Q

What are the differential diagnoses of TB?

A
  • Necrotising pneumonia
  • Histoplasmosis
  • Sarcoidosis
19
Q

What is involved in the management of pulmonary TB?

A

2 months of isoniazid, rifampicin, ethambutol, and pyrazinamide, and then 4 months of isoniazid and rifampicin

20
Q

What is involved in the management of miliary spread of TB?

A

3 months of isoniazid, rifampicin, ethambutol, and pyrazinamide, then 12-18 months of isoniazid and rifampicin

21
Q

What needs to be done once TB is diagnosed?

A

It is a notifiable disease, and contract tracing is required

22
Q

Why is contact tracing required in TB?

A

So those exposed to the patient can undergo tuberculin testing and CXR screening

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