(TB Questions)

MCQ

1)The following are parts of primary tuberculous complex except

A. Initial tuberculous lesion

B. Tuberculous salpingitis

C. Lymphangitis

D. Lymphadenitis

2) The common fate for Ghon’s focus is

A. Fibrosis
B. Blood spread
C. Bronchial spread
D. Direct spread to the pleura
E. None of the above

3) Tuberculous ulcers in the intestine are characterized by the following except

A. Occurs on the terminal ileum
B. Undermined edge
C. Yellow soft floor
D. Parallel to the long axis of the intestine


Short Essay

3. Mention the inflammatory cells forming the tubercle. What are the functions of each cells?

4. What causes ceseation in tuberculous lesions? Describe the appearance of the ceseating material.

5. Enumerate complications of renal tuberculosis.

6. Mention the sites of Tuberculous Osteomyelitis.

7. What are the possible complications of Pott’s disease?


True or False

8. Everyone who gets infected with TB bacteria will get sick.

9. TB infection and TB disease are the same.

10. TB is caused by viral infection.

1.B because this is due to spread of the primary and secondary tuberculosis while the rest from the primary complex
2. A
3. D

3. (i) Epithelioid cells : Form the centre of the tubercle. They phagocytose and destroy the
tubercle bacilli.

(ii) Langhan’s giant cells : Found among the epithelioid cells. They phagocytose the ceseating
material and the tubercle bacilli.

(iii) Lymphocytes : Found in the periphery of the tubercle. They release lymphokines which
have the following actions
- Attract more macrophages to the area of inflammation.
- Stimulate proliferation of the lymphocytes
- Cause caseation in the centre of the tubercle

4. Ceseation is allergic necrosis due to tubercline hypersensitivity ( delayed hypersensitivity ). It is caused by cytotoxic lymphokines released by sensitized T- lymphocytes.
Grossly the ceseating material appears soft, pale yellow and cheesy.
Microscopically it stains homogenous pink with eosin.

5. (i) Haematuria
(ii) Direct spread of infection to the ureter and bladder
(iii) Blood spread of infection causing military tuberculosis
(iv) Chronic renal failure

6. (i) End of long bones : Start in the metaphysic then spread leading to subperiosteal cold
abscess. Direct spread to nearby joints lead to tuberculous arthritis.
(ii) Flat bones : Ribs & pelvis. This is rare. A subperiosteal cold abscess develops.
(iii) Short bones : Hands of feet ( tuberculous dactylitis ). This is rare. The finger or toes
appear fusiform.
(iv) Vertebrae (Pott’s disease)

7. (i) Deformity : Kyphosis results from collapse of the vertebral bodies in front
(ii) Cold abscess : Cervical region, thoracic region, lumbodorsal triangle
(iii) Paraplegia : (10%) It is caused by
- Pressure by inflammatory oedema
- Pressure by cold abscess
- Tuberculous end arteritis causing ischemia
(iv) Miliary tuberculosis


8. False. Not everyone infected with TB bacteria becomes sick. People who become infected, but are not sick have what is called latent TB infection. People who have latent TB infection do not feel sick, do not have any symptoms, and cannot spread TB to others. But, some people with latent TB infection go on to get TB disease. People who have TB disease do feel sick, have signs and symptoms, and may spread TB germs to others.

9. FALSE. TB infection and TB disease are not the same.
TB infection is a condition in which TB bacteria are alive, but inactive in the body. People with latent TB infection have no symptoms, do not feel sick, cannot spread TB germs to others, and usually have a positive TB test. But they may develop active TB disease if they do not receive treatment.
TB disease is an illness in which TB bacteria are growing and attacking the body. People with TB disease have symptoms and feel sick. A person with TB disease can spread TB germs to others, and usually has a positive TB test. People with active TB disease can be treated and cured with proper health care.

10. False. TB is cause by Mycobacterium tuberculosis which is bacterial infection.