Granuloma and Tuberculosis Quiz
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Questions and Answers

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?

  • 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?

  • Apical cavitation
  • Right-sided heart failure
  • Hemoptysis
  • Tuberculous lymphadenitis (correct)
  • Which type of intestinal tuberculosis specifically features tubercles at Peyer's patches?

    <p>Primary intestinal tuberculosis</p> Signup and view all the answers

    What characterizes the dry or adhesive type of tuberculous peritonitis?

    <p>Proliferative (cellular-tubercle forming) reaction</p> Signup and view all the answers

    Which condition is caused by secondary tuberculosis through hematogenous spread?

    <p>Pott's disease</p> Signup and view all the answers

    What are the pathological features of Pott's disease?

    <p>Kyphosis and cold abscess</p> Signup and view all the answers

    What type of tuberculosis primarily manifests as ulcers with undermined edges in the intestine?

    <p>Secondary intestinal tuberculosis</p> Signup and view all the answers

    Which statement about secondary pulmonary tuberculosis is true?

    <p>It is often accompanied by hemoptysis.</p> Signup and view all the answers

    What histological feature is associated with caseation necrosis in tuberculosis?

    <p>Granulomatous inflammation</p> Signup and view all the answers

    What defines a granuloma in the context of tuberculosis?

    <p>A collection of macrophages and inflammatory cells surrounding a pathogen</p> Signup and view all the answers

    Which method of transmission is NOT associated with tuberculosis?

    <p>Direct contact with contaminated surfaces</p> Signup and view all the answers

    What is a primary consequence of the immune response to Mycobacterium tuberculosis?

    <p>Formation of fibrous tissue replacing original tissue</p> Signup and view all the answers

    Which statement best describes caseating necrosis in tuberculosis?

    <p>It is characterized by a cheese-like appearance of necrotic tissue due to immune reactions</p> Signup and view all the answers

    Which population group is at highest risk for developing tuberculosis?

    <p>AIDS patients with compromised immune systems</p> Signup and view all the answers

    What is the primary immune response mechanism against tuberculosis?

    <p>Cell-mediated immunity involving macrophages and T cells</p> Signup and view all the answers

    What is the outcome when Mycobacterium tuberculosis remains dormant within a host?

    <p>Latency leading to potential reactivation later</p> Signup and view all the answers

    Which of the following is a characteristic feature of miliary tuberculosis?

    <p>Widespread presence of tubercle bacilli throughout the bloodstream</p> Signup and view all the answers

    Which factor is NOT contributing to ischemic necrosis in tuberculosis?

    <p>Toxins released by Mycobacterium tuberculosis</p> Signup and view all the answers

    What are Langhans giant cells primarily associated with in tuberculosis?

    <p>Chronic inflammation and granuloma formation</p> Signup and view all the answers

    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.

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