18 TB
Characteristics
- high oxygen content in upper lobe
- mycolic acid makes mycobacterium
- sulfatides: glycolipids on surface, allows survival inside macrophages
Infection
- most people: either clear infection or go into latent phase
- small proportion: primary TB, may resolve or become miliary (systemic, serious)
- may reactivate decades later when immunocompromised
Primary
- very rare to get sick from primary TB
- kill macrophage and spill content
- caseous necrosis: cheese like grossly
- epithelioid: large cells that look like epithelial. Pic: giant cell
- important: hilar, classic for TB and sarcoidosis
- yellow in periphery
- all results of primary exposure
Miliary TB
- name from xray: small white lines on xray looking like millet seeds
Reactivated TB
- primary exposure resolved, either Ghon complex or cleared or latent
Aspergilloma
- complication of reactivation TB
- hemoptysis if big enough
Diagnosis
- inhalation: cough up some sputum
- measure the hardened area, not red area
- can't mount immune response
Treatment
- DOT: pt come in to make sure not miss dosage so no resistant strains
INH
- katG in TB that activates INH
Rifampin
Pyrazinamide
Ethambutol
Streptomycin
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