Tuberculosis

Description

Mind Map on Tuberculosis, created by Chrissy Tee on 24/03/2015.
Chrissy Tee
Mind Map by Chrissy Tee, updated more than 1 year ago
Chrissy Tee
Created by Chrissy Tee about 9 years ago
308
1

Resource summary

Tuberculosis
  1. Cause
    1. Mycobacterium Tuberculosis 1. exposed by inhalation ; 2.In most people the immune system clears the bacteria; 3. Recent resurgence due to HIV
    2. Characteristics
      1. 1. Tubercle --> The typical response takes 3 weeks (time for Type 4 Hypersensitivity reaction. Central caseation surrounded by epetheliod cells. Langerhans cells. Macrophages. Lymphocytes. Surrounded by fibrosis.
        1. 2. Epetheliod cells -->activated macrophages. response to tubercle baccilli mycolic acid. No phagocytic fxn but secretory
          1. 3.Caseation Necrosis --> chalky cheesy. Tissue destroyed with no outline seen. Due to Type 4 hypersensitivity
          2. Clinical Features
            1. Fever; cough with bloody sputum;chest pain; weight loss
            2. Primary Tuberculosis
              1. AKA Ghon's lesion --> Ghon's complex consists of 1. Ghons focus. 2. Lymphatics 3. Hilar lymph node Also PROGRESSIVE PRIMARY TUBERCULOSIS--> rare, involvement of surrounding lung, invades blood vessels and spread -->Miliary TB
              2. Secondary Tuberculosis
                1. Due to 1.reinfection 2. reactivation. Most lesions located at apex. CAVITY FORMATION due to rapid caseation. Also PROGRESSIVE SECONDARY TB --> no healing; direct spread to lungs, pleura, lymph nodes ; bronchiestasis and pleural effusion ; blood spread --> Miliary TB
                2. Miliary Tuberculosis
                  1. Millet sized granulomas all over the lungs, liver, spleen, brain and gut. Occurs in primary or secondary TB. Mycobacterium enters the blood and there is hematogenous spread.
                  2. Laboratory Tests
                    1. Tuberculin (PPD) Test -->inject the tubecle protein into skin. Criteria to treat--> >5mm in HIV+,those with recent contact, chest Xray with old TB scar; >10mm in IV drug users, homeless, those born in countries with high incidence, healthcare workers; >15mm everyone else
                      1. Lab diagnosis of TB -> mimics lung cancer. Do a sputum sample and demonstrate tubercle bacilli by acid fast stain, pcr, culture; fine needle aspiration from lymph node,; lymph node biopsy; bronchoscpoic biopsy; pleural tap
                      2. Tuberculosis in Immunocompromised patients
                        1. EG. In pts with HIV, steroid therapy, lymphoma. -->poor cell reaction so no granulomas; extensive necrosis not caseation; no cavitation or fibrosis; abundant acid fast bacilli; other organisms such as mycobacterium avium intracellulare
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