Tuberculosis Epidemiology and Risk Factors Quiz

Inhaling organism within aerosol droplets expelled by an individual coughing with active disease

Health care workers and prison guards

T cells and macrophages surround the organism to form granulomas

Acid-fast bacilli

Isoniazid daily for 9 months

Resistance to isoniazid and rifampin

Isoniazid, rifampin, ethambutol, and pyrazinamide for 2 months, followed by isoniazid and rifampin for 4 months

To screen for latent tuberculosis infection

Caseating granulomas

≥ 15 mm

6-12 months

Reduce risk factors

Central nervous system

Identification of Mycobacterium tuberculosis in sputum gram stain

High lipid content

T cells and macrophages surrounding the organism to form granuloma

Inhaling organism within aerosol droplets expelled by an individual coughing with active disease

Drenching night sweats

10%

Substance abuse

Tuberculosis is referred to as a 'disease of poverty' because it disproportionately affects individuals living in poverty due to factors such as poor living conditions, malnutrition, lack of access to healthcare, and overcrowding.

Mycobacterium tuberculosis, with its high lipid content, is an acid-fast bacillus that is inhaled into the lungs and primarily affects areas with increased airflow. It leads to symptoms such as dry cough, fever, chills, drenching night sweats, anorexia, and weight loss. The bacilli multiply in macrophages, move through the lymph system and blood, and can lead to extrapulmonary tuberculosis affecting various organs.

Primary TB occurs in 5% of exposed individuals and results in active TB, while latent TB is present in 95% of infected individuals who contain the bacterium without being symptomatic or infectious.

Common risk factors for tuberculosis include being immunosuppressed (e.g., due to HIV, cancer, or steroid use), occupational exposure (e.g., healthcare workers, prison guards), substance abuse (e.g., alcohol), diabetes, malnutrition, and living in areas with poor medical care.

The immune response to Mycobacterium tuberculosis infection involves T cells and macrophages surrounding the organism to form granulomas. In latent TB, 95% of individuals contain the bacterium without being symptomatic or infectious, while in active TB, the immune response may not contain the infection.

Diagnostic studies for tuberculosis include CXR/chest CT, TB skin test, QuantiFERON GOLD blood test, serial sputum smears and cultures, bronchoscopy, and biopsy. The definitive diagnostic methods include the detection of acid-fast bacilli on sputum gram stain and the identification of M. tuberculosis.

Common signs and symptoms of tuberculosis include dry cough, productive cough with or without hemoptysis, fever, chills, drenching night sweats, anorexia, and weight loss. Physical examination findings may include a chronically ill and malnourished appearance, lymphadenopathy, hepatosplenomegaly, hypoxia, and cachexia.

Extrapulmonary tuberculosis refers to the involvement of organs other than the lungs by M. tuberculosis. Examples of its manifestations include CNS tuberculosis leading to meningitis, lymphatic tuberculosis leading to scrofula, pleural tuberculosis leading to TB pleurisy, and disseminated tuberculosis affecting organs such as the bones, joints, and genitourinary system.

Tuberculosis is characterized by the presence of caseating granulomas, also known as necrotizing granulomas. These granulomas are the histologic hallmark of tuberculosis and are significant in the diagnosis of the disease.

The tuberculin skin test (TST) involves the intradermal injection of purified protein derivative (PPD) using the Mantoux method. A positive delayed-type hypersensitivity reaction, indicated by an induration size of $≥ 5$ mm, is interpreted as a positive result, suggesting exposure to tuberculosis and the individual's health status.

The recommended treatment duration for isoniazid prophylaxis in individuals who tested negative in the past but are now positive for tuberculosis with known or unknown exposure is $6-12$ months.

The treatment regimen for active tuberculosis involves a minimum of 2 weeks of therapy with a combination of four drugs: isoniazid, rifampin, ethambutol, and pyrazinamide. After this initial phase, culture and sensitivity testing are performed, and multi-drug therapy is continued for an additional 4 months. The total duration of treatment ranges from 6-9 months.

Multidrug-resistant tuberculosis is defined as resistance to rifampin and isoniazid. The drug regimen for multidrug-resistant tuberculosis is based on the specific drug to which the patient is resistant. Prevention and control measures are essential in managing multidrug-resistant tuberculosis.

Primary prevention of tuberculosis involves reducing risk factors and may include vaccination with the bacille Calmette-Guérin (BCG) vaccine. Secondary prevention focuses on identifying and isolating active cases to prevent transmission, as well as providing appropriate treatment to reduce infectivity.

Primary tuberculosis is characterized by enlargement of the hilar and paratracheal lymph nodes, as well as cavitation with progressive disease and segmental atelectasis. Reactivation tuberculosis typically presents with cavitation and opacities in the right upper lobe (RUL), as well as the presence of Ghon and Ranke complexes.

Management considerations for individuals exposed to active tuberculosis include screening with the tuberculin skin test (TST) and close follow-up. Those with a TST induration size of $>5$ mm are treated aggressively, and certain groups, such as children, adolescents, and immunocompromised individuals, require specific management and follow-up protocols.

The treatment regimen for active tuberculosis involves a minimum of 6 months of therapy with four drugs: isoniazid, rifampin, ethambutol, and pyrazinamide for the first two months, followed by isoniazid and rifampin for an additional 4 months. The treatment regimen for latent tuberculosis infection includes isoniazid daily for 9 months or rifampin daily for 4 months.

Primary tuberculosis is characterized by hilary paratracheal lymph node enlargement, enlargement of lymph nodes of pulmonary hila, and cavitation with progressive disease leading to larger areas of lung tissue death. Reactivation tuberculosis typically presents with cavitation and opacities in the right upper lobe, and the development of Ghon and Ranke complexes, which represent healed primary infection.

The tuberculin skin test involves the intradermal injection of purified protein derivative (PPD) and the measurement of the resulting induration after 48-72 hours. A positive result is indicated by an induration size of 5 mm or greater in individuals with no known risk factors for tuberculosis, 10 mm or greater in recent immigrants, and 15 mm or greater in individuals with no known risk factors for tuberculosis.

The histologic hallmark of tuberculosis is the presence of caseating granulomas, also known as necrotizing granulomas, in affected tissues. These granulomas are significant in the diagnosis of tuberculosis as they provide evidence of mycobacterial infection and help differentiate tuberculosis from other granulomatous diseases.

Primary prevention of tuberculosis involves reducing risk factors and the administration of the Bacillus Calmette-Guérin (BCG) vaccine in countries with a high prevalence of tuberculosis. Secondary prevention strategies include the identification and isolation of active cases, as well as the treatment of latent tuberculosis infection in individuals at risk.

Diagnostic studies for tuberculosis include sputum cultures, DNA (PCR), and RNA amplification techniques. The definitive diagnostic method involves the identification of Mycobacterium tuberculosis in clinical specimens through culture or molecular testing.

Management considerations for individuals exposed to active tuberculosis include screening with the tuberculin skin test (TST), close contact investigation, and initiation of prophylactic treatment in those with a positive TST. Follow-up guidelines involve monitoring for conversion of TST from negative to positive and ensuring completion of the prescribed prophylactic treatment.

Mycobacterium tuberculosis enters the body through inhalation and primarily affects the lungs. The bacteria are phagocytosed by alveolar macrophages and can evade host immune responses, leading to the formation of granulomas. Within the granulomas, the bacteria may remain dormant, leading to latent tuberculosis infection, or become active, causing progressive disease.

Immuno suppression (HIV, cancer, steroids), occupational exposure (health care worker, prison guard), substance abuse (alcohol), diabetes, malnutrition, and poor medical care are common risk factors for tuberculosis.

Mycobacterium tuberculosis, with its high lipid content, is an acid-fast bacillus that is inhaled into the lungs and causes infiltration of neutrophils and macrophages. The organism multiplies in macrophages and can move through the lymph system and blood. It typically leads to symptoms such as cough, fever, night sweats, anorexia, and weight loss.

Tuberculosis is known as a 'disease of poverty' because of its high prevalence in populations with poor living conditions, malnutrition, and limited access to medical care.

Common signs and symptoms of tuberculosis include dry cough, productive cough with or without hemoptysis, fever, chills, drenching night sweats, anorexia, weight loss, and PE findings of chronic illness, malnutrition, lymphadenopathy, hepatosplenomegaly, hypoxia, and cachexia.

Diagnostic studies for tuberculosis include CXR/chest CT, TB skin test, QuantiFERON GOLD blood test, serial sputum smears and cultures, bronchoscopy, and biopsy. The definitive diagnostic methods include acid-fast bacilli detection on sputum gram stain and identification of Mycobacterium tuberculosis.

The treatment regimen for active tuberculosis typically involves a multi-drug approach with isoniazid, rifampin, pyrazinamide, and ethambutol. The duration of treatment is typically 6 months, with an initial 2-month intensive phase followed by a 4-month continuation phase.

The primary mode of transmission for tuberculosis is inhaling the organism within aerosol droplets expelled by an individual coughing with active disease.

10% of individuals infected with tuberculosis will develop the disease.

Caseating granulomas are a histologic hallmark of tuberculosis. Their presence in tissue samples, such as lung biopsies, is highly suggestive of tuberculosis infection.

The recommended treatment regimen for active tuberculosis involves a minimum of 6 months of treatment using a combination of four drugs: isoniazid, rifampin, ethambutol, and pyrazinamide. The initial phase consists of using all four drugs for 2 months, followed by a continuation phase using isoniazid and rifampin for an additional 4 months.

Individuals exposed to active tuberculosis should be screened using the tuberculin skin test (TST). Those with a TST result greater than 5 mm should be treated aggressively. Close contacts, such as children, adolescents, and immunocompromised individuals, should undergo treatment until their TST becomes negative, typically 12 weeks after exposure.

Multidrug-resistant tuberculosis is defined as resistance to both rifampin and isoniazid. The drug regimen for treatment is based on the specific drugs to which the patient is resistant. Prevention emphasizes reducing risk factors and isolating active cases, while treatment involves a drug regimen tailored to the resistance pattern.

Primary prevention of tuberculosis involves reducing risk factors and administering the Bacille Calmette-Guérin (BCG) vaccine. Secondary prevention focuses on identifying and isolating active cases, as well as providing appropriate treatment to reduce infectivity.

Primary tuberculosis is characterized by enlargement of the hilar and paratracheal lymph nodes, while reactivation tuberculosis often presents with cavitation and opacities in the upper lung fields, particularly the right upper lobe.

The treatment regimen for active tuberculosis involves a combination of four drugs (isoniazid, rifampin, ethambutol, and pyrazinamide) for a minimum of 6 months. In contrast, the treatment for latent tuberculosis infection typically consists of isoniazid daily for 9 months or a combination of isoniazid and rifampin for 3 months.

Tuberculosis is often referred to as a 'disease of poverty' because it disproportionately affects socioeconomically disadvantaged populations, where factors such as overcrowding, malnutrition, and limited access to healthcare contribute to the spread and impact of the disease.

T cells and macrophages surround the organism to form granulomas in response to Mycobacterium tuberculosis infection.

Extrapulmonary tuberculosis can manifest in the CNS as meningitis, in the lymphatics as scrofula (of the neck), in the pleura as TB pleurisy, and in other areas such as bones & joints, GU, and disseminated miliary TB.

Common signs and symptoms of tuberculosis include dry cough, productive cough with or without hemoptysis, fever, chills, drenching night sweats, anorexia, and weight loss. Physical exam findings may include chronically ill and malnourished appearance, lymphadenopathy, hepatosplenomegaly, hypoxia, and cachexia.

Diagnostic studies for tuberculosis include CXR/Chest CT for bilateral patchy infiltrates, TB skin test, QuantiFERON GOLD blood test, serial sputum smears & cultures, bronchoscopy, and biopsy. Definitive diagnosis involves the identification of Mycobacterium tuberculosis through acid-fast bacilli on sputum gram stain.

Mycobacterium tuberculosis, with its high lipid content, is an acid-fast bacilli that is inhaled into the lungs where it lands in areas with increased airflow. This leads to infiltration of neutrophils and macrophages, multiplication of AFB within macrophages, and movement through the lymph system and blood. The immune response is initiated with the formation of granulomas.

Extrapulmonary tuberculosis can manifest in various sites such as the CNS, lymphatics, pleura, and other areas. Primary TB occurs in individuals who fail to contain the initial infection, leading to active TB, while latent TB occurs in individuals who contain the bacterium without being symptomatic.

Tuberculosis is transmitted through inhaling organism within aerosol droplets expelled by individuals coughing with active disease. Risk factors include being immunosuppressed (e.g., HIV, cancer, steroids), occupational exposure (e.g., health care workers, prison guards), substance abuse, diabetes, malnutrition, and poor medical care.

Mycobacterium tuberculosis has a high lipid content, making it acid-fast on staining. It can be detected through methods such as TB skin test, QuantiFERON GOLD blood test, sputum smears, cultures, bronchoscopy, and biopsy.

disease of poverty

tuberculosis

tuberculosis

active

macrophages

Mycobacterium

tuberculosis

bones

Primary TB is characterized by the enlargement of hilary paratracheal lymph nodes, enlargement of lymph nodes of pulmonary hila, cavitation with progressive disease, segmental atelectasis, and collapse of one or several segments of a lung lobe.