Tuberculosis

Chrissy Tee
Mind Map by Chrissy Tee, updated more than 1 year ago
Chrissy Tee
Created by Chrissy Tee about 5 years ago
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Description

Mind Map on Tuberculosis, created by Chrissy Tee on 03/24/2015.

Resource summary

Tuberculosis
1 Cause
1.1 Mycobacterium Tuberculosis 1. exposed by inhalation ; 2.In most people the immune system clears the bacteria; 3. Recent resurgence due to HIV
2 Characteristics
2.1 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.
2.2 2. Epetheliod cells -->activated macrophages. response to tubercle baccilli mycolic acid. No phagocytic fxn but secretory
2.3 3.Caseation Necrosis --> chalky cheesy. Tissue destroyed with no outline seen. Due to Type 4 hypersensitivity
3 Clinical Features
3.1 Fever; cough with bloody sputum;chest pain; weight loss
4 Primary Tuberculosis
4.1 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
5 Secondary Tuberculosis
5.1 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
6 Miliary Tuberculosis
6.1 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.
7 Laboratory Tests
7.1 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
7.2 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
8 Tuberculosis in Immunocompromised patients
8.1 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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