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Tuberculosis
OMFP
| Question | Answer |
|---|---|
| What is Tuberculosis (TB) caused by? | It is caused by Mycobacterium tuberculosis. |
| How is Mycobacterium tuberculosis transmitted? | It is transmitted by airborne particles. |
| Describe primary tuberculosis (part 1). | Characteristics include: - Infection with the bacteria of a previously unexposed patient. - Asymptomatic. - Patient may have an infection that results in a long nodule discovered on an x-ray that is asymptomatic. |
| Describe primary tuberculosis (part 2). | Characteristics include: - Can be a progression from infection to disease in 5-10% of patients exposed to this initially. - Infection progression will more likely occur secondary to immunosuppression. |
| Describe secondary tuberculosis (part 1). | Characteristics include: - Result of activation of bacteria. - Because of reactivation, patient will have miliary TB where spread occurs through vascular dissemination. - Patients exhibit cough due to chronic disease. |
| What can long term untreated TB result in? | It can lead to consumption or waste syndrome. |
| What are the head and neck manifestations? | They are: - Cervical lympadenopathy. - Scrofula from drinking contaminated milk. - Larynx, ear, nose and mouth may exhibit chronic painless ulcers or granulomatous lesions. - Radiographically jaw radiopacities present due to calcified lymph nodes. |
| How many people are affected worldwide? | It affects 2 billion people. |
| How many deaths are caused annually? | It causes 2 to 3 million deaths. |
| True or False: The prevalence of TB has declined worldwide with the introduction of effective antimicrobials, but recently it has seen an increased frequency that is associated with AIDS and drug-resistant strains. | True |
| What is the rate of TB in foreign-born individuals in the US? | The rate is 11.5% higher than US born people. |
| What test demonstrates exposure to the bacteria? | The test is PPD - tuberculin or Mantoux test. |
| What is the standard of care? | The standard of care is a biopsy of cutaneous or lung lesions for microscopic diagnosis. |
| What do histopathology and microscopic examination demonstrate? | They demonstrate necrotizing granulomatous inflammation with "Casseous" necrosis. |
| What do tubercles look like when biopsied? | They appear as giant cell granulomas within the tissue. |
| What are the best next steps after tissue biopsy? | One must culture the bacteria or perform PCR to identify bacteria through DNA. |
| Why is multi-agent therapy the standard? | This is due to resistance from genetic mutations. |
| How can patients clear the infection? | This can be done by taking two or more drugs for months to years. |
| What is the course of treatment? | Treatment includes 8 weeks of isoniazid, rifampin and pyrazinamide followed by 16 weeks of isoniazid and rifampin. Some countries give patients the BCG vaccine to protect against spread. |
| What is the prognosis for TB? | For people who live in areas where diagnosis and treatment is available, prognosis is good when following treatment protocols. |
| What is the recurrence rate? | It is low at 0-14% and some may be due to reinfection. |
| What falls under differential diagnosis? | These include the following: - Deep fungal infection. - Sarcoidosis. - Pseudomonal folliculitis. - Primary syphilis. |
Created by:
seema.prakash
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