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22 Cards in this Set
- Front
- Back
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Latent TB
Symptoms infectious? X-ray |
No symptoms, granulomas
Not infectious, not coughing, contained :Pleural scarring, apical calcifications, fibrosis, retraction. Granuloma |
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Gohn Complex
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Calcified pulmonary parenchymal lesion near hilar node.
: Lobes retracted. |
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Active TB
:Clinical :x-ray :dissemination (where) |
: cough, fever, wt. loss, sweats, hemoptysis
:Focal or widespread pneumonia. Many lobe involvement, pleural involvement. Cavities and retracted lobes |
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scrofula
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TB spreading to cervical or other lymphnodes
:not inflammed, tender with fever. Seen in neck |
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TB diagnosis
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1) Chest X-ray
2) PPd 3) QauntiFERON WBC mix w/TB Ag, see if make IFN gamma 4) Clinical specimen AFB stain and culture |
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Factors affecting skin test
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BCG vaccine (ignore after 5 yrs)
:Anergy--overwheliming infection, young, IC, live virus vaccine : booster phenomenon, test 2x |
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Treatment Drugs
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First line: RIPES--rifampin, isoniazid, pyrazinamide (PZA), ethambutol. Streptomycin. RI have hepatotoxicity
Second: PAS, ethionamide, cyclocerine |
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Principles of TB treatment
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Active: Multiple drugs, decrease # of drugs as bacteria decrease, isolate, don't add one drug to failing regimen, failure usually from non-adherence
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Prophylactic TB treatment
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Latent, + PPD, reduce reactivaton, better for new infection, Isoniazid alone (hepatotoxicity)
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BCG vaccine
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Live attenuated, limited efficacy. Prevent CNS disease in children.
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M. Avium (MAC, M.avium complex)
: Where : Colonize? Disease AIDS disease |
: Water, plants, soil
: Transient colonization : Pulmonary MAC ICompo, lymphadenitis in children : AIDS disseminated no HAART, fever, sweats, wt loss, bone marrow probs Where HAART: focal lymphadenopathy |
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M. Marinum
: Where : Disease |
Where: Non-chlorinated H2O
: Papule or nodule. can ulcerate. Fever, local lymphadenopathy. Incubate 2-3 wks |
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m. marinum sporotrichoid
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Bacteria spread from site of inititial infection nodules along lymphatic drainage
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Leprosy (m. leprae)
skin testing |
Fernandez reaction: 48 hrs
Mitsuda: 3 wks. Granuloma. + in tuberculoid, - in lepromatous |
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Lepromatous leprosy
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skin lesions
bacilli Ab fight |
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Tuberculoid Leprosy
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Cell mediated immunity
Nerve damage |
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Tuberculoid Leprosy
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Cell mediated immunity
: no AFB in swabs : elevated plaques w/decreased sensitivity & hypopigmentation :organized granulomas on histo |
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Signs of Leprosy
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Eyebrow alopecia, enlarged earlobes, swelling fingers, enlarged earlobes, hypopigmentation
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Symptoms/signs lepromatous
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Desseminated nodules, infiltraion and thickening of skin.
:disorganized granulomas, foamy macros *few lymphos |
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leprosy management
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Chemo: rifampin, dapsone, clofazamine (in combos)
Anti-inflammatories |
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epidemiology
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:most people don't get it
:HLA genetic predisposition :need long exposure, hard to get |
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Cytokines to transform t-cells
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TH1: IL-12 & IFN gamma--need Vitamin D to activate macros
TH2: IL-4 |
