Tuberculosis Overview and Infection Methods
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Questions and Answers

What is the primary feature of secondary pulmonary tuberculosis?

  • Involvement of lymph nodes
  • Localized lesions in the apices of the lungs (correct)
  • Caseation necrosis as the main symptom
  • Miliary spread through the bloodstream

Which cell types primarily mediate the immune response in tuberculosis?

  • Macrophages, epithelioid cells, and giant cells (correct)
  • Neutrophils and eosinophils
  • B lymphocytes and plasma cells
  • T helper cells and dendritic cells

Which of the following statements is true regarding primary intestinal tuberculosis?

  • It commonly leads to bone lesions
  • It results from the inhalation of airborne particles
  • It exclusively involves the rectum
  • It is caused by the ingestion of contaminated food or milk (correct)

Which of the following features is NOT associated with tuberculous ulcers in secondary intestinal tuberculosis?

<p>Presence of lymphadenitis (C)</p> Signup and view all the answers

What key characteristic distinguishes miliary tuberculosis from secondary pulmonary tuberculosis?

<p>Widespread infection throughout the body (D)</p> Signup and view all the answers

Which component is NOT part of the primary complex in tuberculosis?

<p>Pulmonary infiltrates (B)</p> Signup and view all the answers

What is the primary characteristic of a granuloma?

<p>It organizes inflammatory cells in a circular arrangement. (B)</p> Signup and view all the answers

In the context of intestinal tuberculosis, where are tubercles primarily located?

<p>Ileum and Peyer’s patches (A)</p> Signup and view all the answers

What triggers the process of caseation necrosis in tuberculosis?

<p>Lymphokine interaction between immune cells and tubercle bacilli. (B)</p> Signup and view all the answers

Which cellular response is primarily responsible for hypersensitivity reactions in tuberculosis?

<p>Sensitized T lymphocytes and macrophage-derived lymphokines (D)</p> Signup and view all the answers

Which of the following best describes the potential behavior of Mycobacterium tuberculosis within the host?

<p>It can remain dormant, causing latent infection. (C)</p> Signup and view all the answers

What defines the caseation necrosis seen in tuberculosis?

<p>Development of soft, cheese-like tissue in infected areas (A)</p> Signup and view all the answers

Which group is at the highest risk for developing tuberculosis?

<p>Persons living in malnourished conditions. (C)</p> Signup and view all the answers

What symptom is NOT typically associated with secondary pulmonary tuberculosis?

<p>Weight gain (B)</p> Signup and view all the answers

What is the significance of a Langhans Giant Cell in tuberculosis?

<p>It is formed by the fusion of macrophages. (D)</p> Signup and view all the answers

How is tuberculosis primarily transmitted?

<p>Via inhalation from an active TB patient's respiratory droplets. (C)</p> Signup and view all the answers

What is a notable consequence of the immune response activation in tuberculosis?

<p>Increased necrosis and cytokine production. (B)</p> Signup and view all the answers

Which is NOT a symptom commonly associated with tuberculosis?

<p>Increased appetite. (B)</p> Signup and view all the answers

What does ischemic necrosis in tuberculosis result from?

<p>Endarteritis obliterans leading to reduced blood supply. (A)</p> Signup and view all the answers

What characterizes a caseating tubercle?

<p>Areas of caseation necrosis at the center. (D)</p> Signup and view all the answers

Flashcards

Miliary Tuberculosis

A form of TB where Mycobacterium tuberculosis spreads throughout the body, causing widespread infection.

Secondary Intestinal Tuberculosis

Tubercles forming in Peyer's patches at the terminal ileum. They are multiple, have undermined edges, and heal by fibrosis.

Ghon's Focus

The initial infection site in the lung, often found near the surface of the lung.

Primary Pulmonary Complex

A collection of three features: Ghon's focus, tuberculous lymphangitis, and tuberculous lymphadenitis.

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Immunity in TB

The response to infection from Mycobacterium tuberculosis involving macrophages, epithelioid cells, and giant cells that engulf and try to limit the spread of bacteria.

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Secondary Pulmonary Tuberculosis

Reinfection or reactivation of dormant TB bacteria, typically seen in adults, often affecting the lung apices.

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Primary Intestinal Tuberculosis

Infection from ingesting contaminated milk or food, with TB affecting the intestines and regional lymph nodes.

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Primary Intestinal Complex

The initial infection site in the intestines, involving Peyer's patches, ulcers, and tuberculous lymphangitis.

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Tabes Mesenterica

The formation of tubercles in Peyer's patches and tuberculous lymphadenitis, common in primary Intestinal Tuberculosis.

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Hypersensitivity in TB

A reaction caused by lymphokines from T lymphocytes and macrophages in TB, leading to caseation necrosis - a trademark of TB.

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Granuloma

A chronic, specific inflammatory response where the immune system attempts to isolate a pathogen it cannot eliminate, often leading to tissue damage and scarring.

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Tuberculosis (TB)

A chronic infectious granuloma caused by the bacterium Mycobacterium tuberculosis, often spread through inhalation of infected droplets.

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M. tuberculosis Reproduces Inside Macrophages

The ability for Mycobacterium tuberculosis to reproduce within macrophages, immune cells that are usually meant to destroy pathogens.

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Latent TB Infection

The process where Mycobacterium tuberculosis can remain inactive within the body, leading to a latent infection that may or may not reactivate later.

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Caseation Necrosis

The characteristic tissue damage found within granulomas in TB, often appearing as a cheesy, yellowish substance.

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Hypersensitivity-Induced Caseation Necrosis

A type of caseation necrosis in TB, often triggered by a hypersensitivity reaction between T lymphocytes and bacterial antigens.

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Ischemic Necrosis in TB

A type of caseation necrosis in TB, caused by blood vessel blockage that reduces blood supply to the affected tissue.

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Tubercle (Tuberculous Granuloma)

The basic structural unit of TB infection, characterized by chronic inflammatory cells, caseation necrosis, and fibrosis.

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Langhans Giant Cell

A key microstructural feature of tubercles, created by the fusion of macrophages, often seen in the center of caseous necrosis.

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Caseating Tubercle

Tubercles containing a central area of caseation necrosis, indicating significant tissue damage.

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Study Notes

Tuberculosis Overview

  • Tuberculosis (TB) is a chronic, infectious disease caused by Mycobacterium tuberculosis.
  • It's characterized by granulomas, organized collections of inflammatory cells around pathogens the immune system can't eliminate. Tissue necrosis & fibrosis often occur.

Methods of Infection

  • Inhalation of droplets from an active TB patient's cough or sneeze.
  • Ingestion of contaminated milk.

Host-Bacteria Interaction

  • M. tuberculosis replicates inside macrophages.
  • Macrophages might fail to present antigens to lymphocytes, leading to latent TB.
  • Successful antigen presentation activates the immune response, cytokine production, & tissue necrosis.

Risk Groups

  • AIDS patients.
  • Individuals in overcrowded conditions.
  • Malnourished individuals.
  • Close contacts of active TB patients.
  • Smokers & alcohol users.

Symptoms

  • Chronic cough (possibly with blood).
  • Fever.
  • Night sweats.
  • Weight loss ("consumption").

Mechanisms of Caseation

  • Hypersensitivity: Interaction between lymphokines and TB antigens leads to caseation necrosis.
  • Ischemic Necrosis: Reduced blood supply causes tissue death.

Tubercle Structure

  • The tubercle, the basic structural unit of tuberculosis, consists of chronic inflammatory cells (macrophages & lymphocytes).
  • It includes areas of caseation necrosis and fibrosis around M. tuberculosis.
  • Represents the immune reaction to the bacteria.

Caseating Tubercle

  • Contains regions of caseation necrosis at the center.

Langhans Giant Cells

  • Multinucleated giant cells formed by fusing macrophages, characteristic of tuberculous granulomas.

Miliary Tuberculosis

  • Disseminated form with numerous tubercles throughout the body due to M. tuberculosis spreading via bloodstream.

Immunity & Hypersensitivity in TB

  • Immunity: Mediated by macrophages, epithelioid cells, and giant cells, which engulf bacteria to limit spread.
  • Hypersensitivity: Caused by sensitized T lymphocytes and macrophages, leading to caseation necrosis (a hallmark of TB).

Primary Tuberculosis

  • Ghon's Focus: Initial infection site in the lung (typically subpleural).
  • Primary Complex: Includes Ghon's focus, lymphangitis, and tuberculous lymphadenitis of regional lymph nodes.

Primary Pulmonary Complex

  • Includes Ghon's focus, tuberculous lymphangitis, & tuberculous lymphadenitis of nearby lymph nodes.

Secondary Pulmonary Tuberculosis

  • Reactivation or reinfection of dormant bacteria.
  • Typically seen in adults.
  • Often localized to the apices of the lungs (apical cavitation).
  • Common symptoms include hemoptysis, pneumothorax, right-sided heart failure due to lung fibrosis, and amyloidosis.

Intestinal Tuberculosis

  • Primary Intestinal Tuberculosis: Infection from contaminated milk/food, with tubercles in Peyer's patches; TB ulcers, lymphangitis, & mesenteric lymphadenitis.
  • Secondary Intestinal Tuberculosis: Results from swallowed sputum in pulmonary TB, involving tubercles in Peyer's patches at the terminal ileum.

Fate of Intestinal Tuberculosis

  • Progresses to ulcers with undermined edges and caseous floor.
  • Healing through fibrosis.

Secondary Intestinal Tuberculosis

  • Location: tubercles in Peyer's patches of the terminal ileum.
  • Tuberculous ulcers have multiple, undermined edges, soft caseous floor, and transverse orientation.
  • Healing is via fibrosis.
  • No lymphangitis or lymphadenitis (lymph node swelling).

Tuberculous Peritonitis

  • Secondary form primarily affecting children.
  • Two types: Wet/Ascitic (exudative reaction) & Dry/Adhesive(proliferative reaction, tubercle formation)

Pott's Disease (Spinal Tuberculosis)

  • Secondary spread through the bloodstream.
  • Common sites: Cervical, thoracic, and lumbar vertebrae.

Pathological Features

  • Kyphosis: Forward curvature of the spine.
  • Cold Abscess: Non-pyogenic abscess formation.
  • Paraplegia: Paralysis due to spinal cord compression.

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This quiz covers the key aspects of tuberculosis, including its causative agent, transmission methods, risk groups, and symptoms. Explore how tuberculosis interacts with the immune system and the mechanisms behind the disease's progression.

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