18 TB

Characteristics

• high oxygen content in upper lobe

• mycolic acid makes mycobacterium

• sulfatides: glycolipids on surface, allows survival inside macrophages

Infection

• latent: wall it off

• 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

• false positive

Treatment

• DOT: pt come in to make sure not miss dosage so no resistant strains

INH

• katG in TB that activates INH

• numbness in extremities

Rifampin

Pyrazinamide

Ethambutol

Streptomycin