TUBERCULOSIS

37 cards   |   Total Attempts: 182
  

Cards In This Set

Front Back
Infectious agent in TB?
Mycobacterium tuberculosis
From the lungs, how does TB spread?
Via lymphatics. First --> mediastinal lymph nodes
What's the immune response to TB in 90-95% of immunocompotent people?
Cellular immune response--> macrophages ingest M. tuberculosis--> granuloma forms (takes 3-9 weeks)...after this time, tuberculin skin test becomes +!
In a minority of pts, what's the early immune response to TB?
Response is super robust--> severe necrosis--> cavity formation or local extension of disease...in others, dissemination occurs very early, with systemic spread to extrapulmonary sites (pericardium, extrapulmonary lymph nodes (scrofula), kdineys, epiphyses of long bones, vertegral bodies, and meninges
What's the purpose of a granuloma?
Contains the infection! ...with waning cellular immunity (eg: with age, advancing HIV, malig, or corticosteroid admin), these organisms may escape from the granuloma--> tb reactivation :(
What factors have--> increase in TB in North America?
HIV epidemic, multi-drug resistant M. tuberculosis
Transmission usually requires _____ _____ of _____ contact with the exception of pts with ______ or ______ disease
Several months; close; endobronchial; cavitary
4 imp risk factors for developing active TB?
*older age (often thought to be reactivation)
*lower socioecon class (via crowding, homelessness, poor nutrition, etc)
*recent (<5 yrs) immigrant from area with high prevalence (eg eastern europe, latin america, asia, and africa)
*HIV +
Though early TB is usually asymptomatic, what types of symptoms occur in later disease?
Nonspecific, constitutional symptoms, like:
Fevers, chills, night sweats
anorexia
wt loss
fatigue
cough
What symtpom denotes adv TB?
Hemoptysis
Pulmonary findings of TB?
Dullness
Decreased Fremitus
may have pleural effusion or pleural thickening
may have signs of consolidation
cavity may--> distant hollow breath sounds that suggest teh sound of blowing across the mouth of a jar (AMPHORA)
Extrapulmonary TB is manifest by signs of the _____ _____ ____ ____
Particular organ system involved
How does skeletal TB manifest?
Spine pain and tenderness
How does tuberculous adenitis manifest?
Cervical adenopathy (scrofula)
DDx of TB?
Fungal diseases (histoplasmosis, coccidiodomycosis)
Sarcoidosis
Malig