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Tuberculosis (People at risk (Overcrowded conditions, Young, Poorly…
Tuberculosis
Diadnosis
Mantoux test (positive test indicates hypersensitivity to mycobacterial antigens and suggests latent infection. Performed by injecting 0.1ml of PPD intermediately. Flase positive if the patient had the BCG vaccine, False negative if the patient has had Sarcoidosis)
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Infection
Post primary infection
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Pulmonary tuberculosis This is a chronic latent reactivation of TB that is found in the oxygen rich apical lobes of the lungs.
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Primary infection
Pulmonary tuberculosis occurs when the mycobacterial infection enters the lungs through inhalation. Once they're in the lungs they can be found in the lower lobes which are mostly perfused with blood vessels. This will cause them to disseminate through the body and cause further infection. In order to become a latent bacterial infection the mycoplasma cells induce hypersensitivity. Some if the of the bacilli are phagocytosed by alveolar macrophages and transported to hilar nodes. Some naive cells cannot kill the bacilli which end up multiplying, they lyse the host cell and infect other macrophages and end up disseminating throughout the body. Some of the Bacilli that stay in the lungs form a Ghon complex which ends up forming a scar in the lung parenchyma and hilar nodes (if they have been phagocytosed)
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Treatment/Management
Rifampin
Hepatotoxicity, Enzyme inducers, orange secretion
bacteriocidal antiTB drug that kills both multiplying and dormant bacteria hence it sterilizes the tissue
Isoniazid
Hepatotoxicity, peripheral neuropathy
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Pyrazinamide
Hepatotoxicity, precipitate gout, B6 deficiency
Ethambutol
Optic neuritis, color blindness
Sterptomycin
Ototoxicity, nephrotoxicity, insafe in pregnanvy
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