Podcast
Questions and Answers
What mechanism primarily leads to hypersensitivity in primary tuberculosis?
What mechanism primarily leads to hypersensitivity in primary tuberculosis?
- Direct infection of tissues by bacteria
- Cytokine secretion by B lymphocytes
- Antigen presentation by macrophages
- Lymphokines secreted by sensitized T lymphocytes (correct)
Which of the following constitutes the triad associated with Ghon's complex?
Which of the following constitutes the triad associated with Ghon's complex?
- Adult type tuberculosis, apical cavitation, hemoptysis
- Ghon's focus, pulmonary fibrosis, tuberculous ulcers
- Primary pulmonary complex, primary intestinal complex, right-sided heart failure
- Ghon's focus, tuberculous lymphangitis, tuberculous lymphadenitis (correct)
In secondary pulmonary tuberculosis, which symptom is typically not observed?
In secondary pulmonary tuberculosis, which symptom is typically not observed?
- Apical cavitation
- Right-sided heart failure
- Hemoptysis
- Tuberculous lymphadenitis (correct)
Which type of intestinal tuberculosis specifically features tubercles at Peyer's patches?
Which type of intestinal tuberculosis specifically features tubercles at Peyer's patches?
What characterizes the dry or adhesive type of tuberculous peritonitis?
What characterizes the dry or adhesive type of tuberculous peritonitis?
Which condition is caused by secondary tuberculosis through hematogenous spread?
Which condition is caused by secondary tuberculosis through hematogenous spread?
What are the pathological features of Pott's disease?
What are the pathological features of Pott's disease?
What type of tuberculosis primarily manifests as ulcers with undermined edges in the intestine?
What type of tuberculosis primarily manifests as ulcers with undermined edges in the intestine?
Which statement about secondary pulmonary tuberculosis is true?
Which statement about secondary pulmonary tuberculosis is true?
What histological feature is associated with caseation necrosis in tuberculosis?
What histological feature is associated with caseation necrosis in tuberculosis?
What defines a granuloma in the context of tuberculosis?
What defines a granuloma in the context of tuberculosis?
Which method of transmission is NOT associated with tuberculosis?
Which method of transmission is NOT associated with tuberculosis?
What is a primary consequence of the immune response to Mycobacterium tuberculosis?
What is a primary consequence of the immune response to Mycobacterium tuberculosis?
Which statement best describes caseating necrosis in tuberculosis?
Which statement best describes caseating necrosis in tuberculosis?
Which population group is at highest risk for developing tuberculosis?
Which population group is at highest risk for developing tuberculosis?
What is the primary immune response mechanism against tuberculosis?
What is the primary immune response mechanism against tuberculosis?
What is the outcome when Mycobacterium tuberculosis remains dormant within a host?
What is the outcome when Mycobacterium tuberculosis remains dormant within a host?
Which of the following is a characteristic feature of miliary tuberculosis?
Which of the following is a characteristic feature of miliary tuberculosis?
Which factor is NOT contributing to ischemic necrosis in tuberculosis?
Which factor is NOT contributing to ischemic necrosis in tuberculosis?
What are Langhans giant cells primarily associated with in tuberculosis?
What are Langhans giant cells primarily associated with in tuberculosis?
Flashcards
Granuloma
Granuloma
A chronic specific inflammation characterized by a circular collection of macrophages and other inflammatory cells surrounding a pathogen. It forms when the immune system tries to contain a pathogen it can't eliminate.
Tuberculosis
Tuberculosis
A chronic infectious disease caused by the bacteria Mycobacterium tuberculosis, leading to the formation of granulomas.
Inhalation
Inhalation
Tuberculosis infection spread through the air by coughing or sneezing from an active tuberculosis patient.
Ingestion of contaminated milk
Ingestion of contaminated milk
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TB bacteria reproduction inside macrophages
TB bacteria reproduction inside macrophages
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Macrophages unable to present antigen
Macrophages unable to present antigen
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Latent TB infection
Latent TB infection
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Immune response activation
Immune response activation
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Caseation necrosis
Caseation necrosis
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Tubercle (Tuberculous granuloma)
Tubercle (Tuberculous granuloma)
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Secondary pulmonary tuberculosis
Secondary pulmonary tuberculosis
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Primary intestinal tuberculosis
Primary intestinal tuberculosis
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Tuberculous peritonitis
Tuberculous peritonitis
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Pott's disease
Pott's disease
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Ghon's focus
Ghon's focus
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Primary pulmonary complex
Primary pulmonary complex
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Tuberculous ulcers
Tuberculous ulcers
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Tuberculous lymphangitis
Tuberculous lymphangitis
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Tabes mesenterica
Tabes mesenterica
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Secondary intestinal tuberculosis
Secondary intestinal tuberculosis
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Study Notes
Granuloma
- Granuloma is a chronic specific inflammation
- It's a collection of macrophages and other inflammatory cells around a pathogen
- The immune system tries to surround the pathogen, when it cannot eliminate it
- Granuloma leads to necrosis and tissue replacement by fibrosis
Tuberculosis
- Tuberculosis is a chronic infectious granuloma caused by Mycobacterium tuberculosis
- Tuberculosis is spread through inhalation of active TB patient's cough or sneeze or through ingestion of contaminated milk
- M. tuberculosis can reproduce inside macrophages
- Macrophages are unable to present the antigen to lymphocytes
- Bacteria can become dormant, causing a latent infection
- If macrophages present the bacteria to lymphocytes, the immune system reacts with cytokines and tissue necrosis
Risk Groups and Symptoms of Tuberculosis
- Risk factors include AIDS, overcrowding, malnutrition, close contact with active patients, smoking, and alcohol use
- Symptoms include chronic cough (often with hemoptysis), fever, night sweats, and weight loss
- "Consumption" was the historical term used for TB, due to weight loss
Mechanisms of Caseation
- Hypersensitivity: occurs between lymphokines secreted by T lymphocytes and macrophages and antigen of tubercle bacilli (tuberculoprotein)
- Ischemic necrosis: due to endarteritis obliterans
Immune Reaction against Tuberculosis
- Primary pulmonary tuberculosis (0-3 weeks): unchecked bacillary proliferation, alveolar macrophages, mannose-capped glycolipid, macrophage mannose receptor, and NRAMP1 polymorphism leading to endosome manipulation
- Primary pulmonary tuberculosis (>3 weeks): "activated" macrophages, IFN-gamma, TNF-alpha, chemokines, monocyte recruitment, nitric oxide and free radicals, epithelioid granuloma, tuberculin positivity ("hypersensitivity"), bactericidal activity ("immunity")
Tubercle (Tuberculous Granuloma)
- A tubercle is the basic unit of tuberculosis
- It's a microscopic structure of chronic inflammatory cells, caseous necrosis, and fibrosis around tubercle bacilli
- Represents the tissue reaction against TB bacilli
Pott's Disease
- Pott's Disease is a secondary form of tuberculosis caused by blood spread
- It affects the cervical, thoracic, and lumbar sites
- Characteristic features include kyphosis, cold abscess, and paralysis (paraplegia)
Miliary Tuberculosis
- A large number of Mycobacterium tuberculosis travel through the blood and spread throughout the body
Immunity and Hypersensitivity in Tuberculosis
- Immunity: cell-mediated (macrophages, epithelioid cells, and giant cells) to engulf and prevent spread
- Hypersensitivity: due to lymphokines secreted by sensitized T lymphocytes/macrophages, causing necrosis (caseation)
Primary Tuberculosis
- Ghon's focus, tuberculous lymphangitis, and tuberculous lymphadenitis of regional lymph nodes are the triad of the primary pulmonary complex
Secondary Pulmonary Tuberculosis
- Second infection or reactivation of tuberculosis
- Affects adults
- Apical cavitation occurs
- Lymph nodes are not involved
- Hemoptysis may occur
- Pneumothorax, right-sided heart failure due to lung fibrosis, and amyloidosis are potential complications
Intestinal Tuberculosis
- Primary intestinal tuberculosis includes primary intestinal complex and tubercles at Peyer's patches
- Other aspects include TB ulcers, tuberculous lymphangitis, and tabes mesenterica
Tuberculous Peritonitis
- A secondary type of tuberculosis, common in children
- Two types: wet/ascetic (exudative reaction) and dry/adhesive (proliferative/cellular-tubercle forming reaction)
Secondary Intestinal Tuberculosis
- Tubercles typically are in the Peyer's patches of the terminal ileum
- Ulcers are characterized by: multiple, undermined edges, soft caseous floor, transverse, healing by fibrosis
- Lymphangitis and lymphadenitis are absent
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Description
Test your knowledge on granulomas and their role in tuberculosis. This quiz covers the inflammation process, the pathogen involved, risk factors, and symptoms associated with TB. Learn how the immune system interacts with Mycobacterium tuberculosis and the implications of chronic inflammation.
