Tuberculosis

Question 1

How does ileocecal tuberculosis present?

Answer 1

Weight loss, fever and night sweats
Palpable mass in lower quadrant
Abdominal pain

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Question 2

What is used for diagnosis of TB?

Answer 2

Early morning samples

Question 3

How does TB appear on CXR?

Answer 3

Patchy opacification across both upper zones

Question 4

What is a risk of a cavitating lesion?

Answer 4

Lung abscess
Aspergilloma

Question 5

How does lung abscess present?

Answer 5

Excess large amounts of blood
Central cavitation with air fluid level

Question 6

How does aspergillomas present?

Answer 6

Aspergilloma is when aspergillosis fungus clumps tougher in lung cavity and is usually asymptomatic

Question 7

Which tuberculosis drug causes peripheral neuropathy?

Answer 7

Isoniazid due to B6 depletion so it must be taken with pyridoxine. Other side effects include hepatotoxicity, optic neuritis and gout

Question 8

What are the side effects of pyrazinamide?

Answer 8

Arthralgia
Myalgia
Gout
Hepatotoxicity

Question 9

What are the side effects of ethambutol?

Answer 9

Optic neuritis

Question 10

What are the side effects of rifampicin?

Answer 10

Orange discouraging of secretions
Flu-like symptoms
Hepatotoxicity

Question 11

Which drug is used in treating drug-resistant TB?

Answer 11

Amikain, with main side effects being toxicity and nephrotoxicity.

Question 12

What is the test for active TB?

Answer 12

Sputum acid-fast smear

Question 13

What is the test for latent TB?

Answer 13

Interferon gamma release assay, cannot differentiate between active and latent.

Question 14

What are the types of altitude sickness.

Answer 14

*Acute mountain sickness
*High altitude pulmonary oedema
*High altitude cerebral oedema

Question 15

What is acute mountain sickness?

Answer 15

Acute mountain sickness is generally a self-limiting condition. Features of AMS start to occur above 2,500 - 3,000m, developing gradually over 6-12 hours and potentially last a number of days

Question 16

How does acute mountain sickness present?

Answer 16

headache
nausea
fatigue

Question 17

What is acute mountain sickness correlate with?

Answer 17

Physical sickness

Question 18

How to prevent acute mountain sickness?

Answer 18

gain altitude at no more than 500 m per day And addition of acetazolamide.

Question 19

How to prevent acute mountain sickness?

Answer 19

gain altitude at no more than 500 m per day And addition of acetazolamide.

Question 19

How does Acetazolamide prevent mountain sickness!

Answer 19

it causes a primary metabolic acidosis and compensatory respiratory alkalosis which increases respiratory rate and improves oxygenation

Question 20

How to treat acute mountain sickness?

Answer 20

Descent

Question 21

How does high altitude pulmoanry oedema occur?

Answer 21

hypobaric hypoxia → uneven hypoxic pulmonary vasoconstriction → uneven blood flow in the lungs → areas of the lung receiving more blood experience an increase in capillary pressure → more fluid leakage. Hypoxia may also directly increase capillary permeability, exacerbating fluid leakage into the alveolar space.

Question 22

What is the presentation of high altitude pulmonary oedema?

Answer 22

Coarse bilateral crackles
Shortness of breath
Fluid overload

Question 23

How does high altitude cerebral oedema present!

Answer 23

Hypoxia → cerebral vasodilation → elevated cerebral blood volume
also, hypoxia → increase in the permeability of the blood-brain barrier → capillaries in the brain more leaky → leading to fluid accumulation in the extracellular spaces

Question 24

How does high altitude cerebral oedema present?

Answer 24

headache, ataxia, papilloedema

Question 25

How to manage high altitude cerebral oedema?

Answer 25

Descent and dexamethasone

Question 26

How to amangement HAPE?high altitude pulmoanry oedema!

Answer 26

*descent *nifedipine, dexamethasone, acetazolamide, phosphodiesterase type V inhibitors* *oxygen if available

Question 27

What hormone disorder may develops after TB?

Answer 27

Addison’s disease

Question 28

Which investigation is reccomended for vaccinated people exposed to TB.

Answer 28

Interferon gamma release assay