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Cards In This Set
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Infectious agent in TB?
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Mycobacterium tuberculosis
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From the lungs, how does TB spread?
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Via lymphatics. First --> mediastinal lymph nodes
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What's the immune response to TB in 90-95% of immunocompotent people?
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Cellular immune response--> macrophages ingest M. tuberculosis--> granuloma forms (takes 3-9 weeks)...after this time, tuberculin skin test becomes +!
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In a minority of pts, what's the early immune response to TB?
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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
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What's the purpose of a granuloma?
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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 :(
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What factors have--> increase in TB in North America?
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HIV epidemic, multi-drug resistant M. tuberculosis
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Transmission usually requires _____ _____ of _____ contact with the exception of pts with ______ or ______ disease
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Several months; close; endobronchial; cavitary
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4 imp risk factors for developing active TB?
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*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 + |
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Though early TB is usually asymptomatic, what types of symptoms occur in later disease?
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Nonspecific, constitutional symptoms, like:
Fevers, chills, night sweats anorexia wt loss fatigue cough |
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What symtpom denotes adv TB?
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Hemoptysis
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Pulmonary findings of TB?
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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) |
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Extrapulmonary TB is manifest by signs of the _____ _____ ____ ____
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Particular organ system involved
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How does skeletal TB manifest?
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Spine pain and tenderness
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How does tuberculous adenitis manifest?
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Cervical adenopathy (scrofula)
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DDx of TB?
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Fungal diseases (histoplasmosis, coccidiodomycosis)
Sarcoidosis Malig |
