Respiratory

  • Tuberculosis

  • Which organism is responsible for causing tuberculosis (TB)?

  • Mycobacterium tuberculosis

  • What type of organism is Mycobacterium tuberculosis?

  • Acid-fast bacillus

  • Which stain is commonly used with microscopy for rapid diagnosis of TB?

  • Ziehl-Neelsen stain

  • Approximately how long does culture take for detectable growth of Mycobacterium tuberculosis?

  • 2 to 6 weeks

  • What duration of cough should alert a suspicion of TB?

  • 2 weeks or more

  • Ideally how many sputum samples should be sent for acid-fast bacilli (AFB)

  • 3 samples

  • List 2 methods of obtaining sputum samples

  • 1) Spontaneous coughing

    2) Induced by saline nebuliser

  • How many hours apart should the sputum samples be?

  • At least 8 hours apart, 8- to 24-hour intervals

  • What time of day should the sputum samples be obtained?

  • At least one early-morning sample

  • Define drug-resistant TB

  • Identification of Mycobacterium tuberculosis with sensitivity testing showing resistance to one or more anti-tuberculous agents

  • Microscopy of biopsy tissue typically shows what appearance?

  • Granulomatous inflammation

  • Describe the characteristic finding of the centres of tuberculous granulomas

  • Caseous (‘cheese-like’) necrosis

  • List 3 cell types characteristically seen in tuberculous granulomas

  • 1) Epithelioid macrophages

    2) Langhans giant cells

    3) Lymphocytes

  • Is serological testing helpful in the diagnosis of TB?

  • No

  • Approximately what percentage of individuals with TB antibodies develop active disease?

  • 10%

  • What traditional culture media is commonly used for growth of mycobacteria?

  • Lowenstein-Jensen

  • Culture-based drug sensitivity testing should be performed for at least which 4 drugs?

  • 1) Isoniazid

    2) Rifampicin

    3) Pyrazinamide

    4) Ethambutol

  • List the 3 commonest abnormalities seen on chest X-ray

  • 1) Hilar lymphadenopathy

    2) Pleural effusion

    3) Pulmonary consolidation

  • Approximately what percentage of patients will show solitary cavitation on CT chest?

  • Up to 10%

  • List 2 pericardial complications of TB

  • 1) Pericardial thickening

    2) Pericardial effusion

  • Is TB a notifiable disease in the UK?

  • Yes

  • Within what time period must confirmed or suspected TB be notified?

  • Within 3 working days

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