TB = Tuberculosis

*RIPE therapy

  • "PRIZE winning Ethan Hawke IS right fucked (RIPE for short) "

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Primary vs Secondary Tuberculosis

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Mycobacteria

  • acid fast rod bacteria
    --> Ziehl–Neelsen staining
  • do not gram stain

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*Granuloma Formation of TB

  • Giant cells = Langerhan's Cells
    --> activated macrophages join together to form these cells and have a ring of nuclei around the edges
  • Langerhans form the granuloma surrounding the mycobacteria tuberculosis

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Clinical Cases

Clinical Case

Notes:

  • note that

Clinical Case

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Notes:

  • note that at the very start of TB infecions due to the virulence factor = CORD FACTOR of TB, they live and grow within macrophages
  • they inhibit the phagolysosome formation to destroy them
  • eventually the macrophages learn that they are infect and display the APC MHC 2 to CD 4 cells
  • the CD$ cells are then the amin activator that activate the macrophages
  • macrophages can then differentiate into LAngerhans giant cells to try and wall off the mycobacteria into granulomas

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*Macrophage Differentiation

  • epithelioid Macrophages
  • Langerhan's Cells

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*Epithelioid Cells

  • activated macrophages

*Langerhan's Cells

  • Giant cells = Langerhan's Cells
    --> activated macrophages join together to form these cells and have a ring of nuclei around the edges
  • Langerhans form the granuloma surrounding the mycobacteria tuberculosis

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*Histology of Mycobacterium Tuberculosis

  • classic long serpentine cord like arrangement
    --> cord factor = main virulence factor
  • acid fast stain = Zeil Neilson stain
    --> only TB and Nocardia are positive
    --> binds mycolic acid

Acid Fast Staining / Ziel Neilson Stain

  • only Nocardia and mycobacteria tuberculosis are acid-fast
  • first stain with analine dye = carbolfuscin = red dye
    --> binds with mycolic acid
  • then alcohol to wash away non-acid fast cell walls
  • counterstain blue

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Cord factor = virulence factor of TB

  • main virulence factor of TB
  • makes long cords that surround it and prevent the acidification in phagolysosomes of macrophages
  • also helps form caseating granulomas in the lungs

*TB classic long serpentine cord like arrangement

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TB television with fast LEMONS on it - HITLER on TB and GRANULATOUS CHEESE EATING GRANNY LAMA

  • CHEESE EATING GRANNY LAMA = caseating granulomas
  • HITLER on TB = hilar lymph nodes of lung spread
  • the FAST LEMONS try to escape off the TB TV
    --> acid fast stain for TB
  • CORD FACTOR chases after one particular RED STAIND CAR BOMB FUSE holding lemon
    --> cord factor = virulence factor for TB TV
    --> think the CORD FACTOR is what gives the TB TV life and power
    --> RED STAINED CAR BOMB LEMON escaping from the CORD FACTOR and TB TV
    --> TB stains red on Carbelfusion stain

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RIPE tx for TB


pyrazinamide

  • "Pirates"

ethambutol
--> Ethan Hawke vampire eyes
--> optic neuropathy


Isoniaozid
--> part of SICKFACES.COM CYP inhibitors
= hepatotoxicity
--> also neurotoxicity (Vit B6 with it always)
--> isoniazid IS in need of VB6 (neurotoxicity)


Rifampin

  • GI symptoms

*Isoniaozid

  • used as part of RIPE
  • get resistance to it if you use it as a monotherapy

*Isoniaozid resistance

  • get resistance to it if you use it as a monotherapy
  • 2 methods of resistance
  • 1 = Isoniazid has to be first activated by TB
  • 2 the protein that Isionizid binds gets mutated

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