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Tuberculosis - Coggle Diagram
Tuberculosis
complications of tuberculosis infection
and reducing the prevalence
TB pericarditis
TB meningitis
Pneumothorax
Venous thromboembolism
Lung cancer
Bronchiectasis
Acute respiratory distress syndrome
massive hemoptysis
Genitourinary TB
Pott disease
spinal infection
Intestinal TB
signs and symptoms of tuberculosis
Fever results from
coughing that last 3 or more weeks
hemoptysis
chills
loss of appetite
Fever
Night sweats
Fatigue
unintentional weight loss
chest pain
Prevention of tuberculosis
treating to prevent further complications
wearing face masks
BCG vaccine
Self isolation
Avoiding crowded places
Education and awareness
Maintaining clean hygiene
Room ventilation
completing medication coarse
Investigations for tuberculosis
to diagnose and give the proper treatment
Radiology
chest x-ray
Labs
sputum
Acid fast bacilli smear microscopy
Mycobacterial culture
Blood
HIV serology
Nucleic acid amplification tests (NAATs)
Tuberculin skin test (TST) with purified protein derivative (PPD)
Pathology of tuberculosis
immune system is activated
Primary tuberculosis
is the form of disease that develops in a previously unexposed / unsensitized patient
First 3 weeks
Mycobacteria Entry into alveolar macrophages
Mycobacteria Replication in macrophages
After 3 weeks of exposure
Development of cell-mediated immunity
T cell mediated macrophage activation and killing of bacteria
Granulomatous inflammation and tissue damage
Secondary tuberculosis
is the pattern of disease that arises in a previously exposed / sensitized host (Reactivation tuberculosis)
Histopathological findings
caseous necrosis
granuloma
Langerhans cells (giant multinucleated cells)
Epidemiology of tuberculosis
to eradicate tuberculosis infections
Tuberculosis is the second leading infectious killer
Tuberculosis is the 13th leading cause of death
Global burden of TB
10 million develop TB each year
1.6 million die from TB
1.7 billion infected with M. tuberculosis
Microbiology of tuberculosis
TB disease result in signs and symptoms
Mycobacteria classifications
Mycobacterium tuberculosis complex (MTC)
M. Tuberculosis
M. Bovis
M. Africanum
Mycobacterium other than tuberculosis (MOTT)
Scotochromogens
M. szulgai
M. scrofulaceum
M. xenopi
Nonchromogens
M. haemophilum
M. avium complex
M. ulcerans
Photochromogens
M. kansasii
M. marinum
Rapid growers
M. abscessus
M. chelonae
M. fortuitum
Noncultivatable mycobacteria
M. leprae
Mycobacterium
long, slender, straight bacilli
Intracellular pathogen
Slow growers
Obligate aerobes
require complex media
Lowenstein jensen
all mycobacteria stain acid fast bacilli (AFB)
Ziehl - Neelsen stain
Pharmacological managements for tuberculosis
and educate the people about the prevention
First line drugs
Rifampin
Isoniazid
Pyrazinamide
Ethambutol
Second line drugs
Aminoglycosides
Floroquinolones
Bedaquiline
Para aminosalicylate (PAS)
Ethionamide
Cycloserine
Macrolides
Capreomycin
Pathophysiology of fever
specific events happened during pulmonary tuberculosis
Fever is elevation of the core body temperature above the normal range
which is often secondary to a pathological process that involves the release of immunological mediators (cytokines) to trigger the thermoregulatory center of the anterior hypothalamus.
Pyrogens are fever-inducing substances
endogenous
(from inside the body) such as interleukin 1 (which is the most potent pyrogenic cytokine), interleukin 6, TNF (tumor necrosis factor alpha), IFN (interferon gamma)
exogenous
(from outside the body) such as bacterial products, bacterial toxins, whole microorganisms (bacteria, virus, fungus, etc…)
Respiratory physical examination
and further investigations
Introduction and exposure
General examination
Chest examination
other examinations
closure
Sacral edema and Peripheral edema
Check for JVP
Anterior
Posterior
inspection
Palpation
Percussion
Auscultation
general inspection
Neck
Face
Hands
Heart rate
Respiratory rate
immunity against tuberculosis
so its important to perform PE
adaptive immune responses to Mycobacterium tuberculosis have delay in the onset of detectable T-cell responses
Delayed migration of dendritic cells from the lungs to the local lymph node.
Pathogen inhibition of apoptosis
Delay in the onset of detectable T-cell responses, in both humans and experimental animals.
Influence of regulatory T cells and its cytokines (mainly IL-10 and TGF-beta).