Extrapulmonary TB

  Рет қаралды 44,072

the study spot

the study spot

8 жыл бұрын

Handwritten video lecture on Extrapulmonary TB for USMLE Step 1 and USMLE Step 2. Will be discussing pathophysiology, signs and symptoms, diagnosis and treatment.
Tuberculosis (TB) can affects sites outside the lung. The most common sites tuberculosis (TB) can occur outside the lungs is the lymph node, pleura, genitourinary tract, bones and joints, meninges, peritoneum and pericardium. Now extrapulmonary Tuberculosis (TB) is more common due to the presence of HIV.
LYMPHATIC TUBERCULOSIS (TB)
Most commonly affect the posterior cervical lymph node and supraclavicular lymph node known as scrofula. Usually presents as painless swelling. May have a fistulous tract and casseous material.
PLEURAL TUBERCULOSIS (TB)
Due to hypersensitivity reaction or direct spread. Generally associated with dullness and decrease breath sounds consistent with pleural effusion. Thoracocentesis will show straw colored fluid high in protein but low in glucose. Generally alkaline fluid with ADA and lysozyme positive. AFB Microscopy and AFB culture and biopsy is helpful in diagnosis.
GENITOURINARY TUBERCULOSIS (TB)
Patient will complain of dysuria, frequency, Nocturia and hematuria. If upper urinary tract may complain of flank abdominal pain. If asyptomatic may present wit hydronephrosis strictures. Urinalysis will show pyruia, hematuria without bacteria. IV pyelography and CT /MRI are also necessary to diagnosis deformities. Male will have epididymis, orchitis, prostitis.
BONE AND JOINT TUBERULCOSIS (TB)
If affects the vertebral column then known as Pott’s Disease. Tenderness at area of infection. X-ray CT is diagnostic.
MENINGITIS
Most common in children and HIV. Present with headache mental changes and neck rigidity with underlying fever and malaise. Base of the brain will cause effect on cranial nerve palsies, such as oculomotor nerve palsies. Patient may get coma hydrocephalus. CSF analysis shows leukocyte, low glucose, low protein, CSF Smear yields AFB. Culture is gold standard and PCR has 80 percent sensitivity.
GASTROINTESTINAL TUBERCULOSIS (TB)
Due to swallowing, Hematogenous spread or cow’s milk (Mycobacterium bovine). Symptoms abdominal pain, swelling, obstruction, hematochezia, palpable mass, fever, night sweats, weight loss.
PERITONITIS TUBERCULOSIS (TB)
Due to rupture, Hematogenous spread, intraabdominal organs. Paracentesis shows exudative fluid, high protein, and high WBC.
OTHER FORMS OF EXTRAPULMONARY TUBERUCLOSIS (TB)
Pericardial
Eye - chiorioretinitis, uveitis, panopthalmitis
Ear - TM perforation, hearing loss
Cutaneous, mastitis
Adrenal insufficiency
Congenital TB and Transplacental TB

Пікірлер: 18
@neillakash1649
@neillakash1649 2 жыл бұрын
Really nice brother.. U wer literally revising harrison.. here😎🙌
@amyp8257
@amyp8257 3 жыл бұрын
Thank you. This was very interesting and informative!
@paulinamloka2817
@paulinamloka2817 5 жыл бұрын
Just amazing... thanks
@layanalnosani9577
@layanalnosani9577 3 жыл бұрын
Awesome! Thank u so much
@MdNaukhezAnwar
@MdNaukhezAnwar 2 жыл бұрын
it can be understood that it may associated with paratrigeminal syndrome (raders syndrome )
@Mylittlethings_..
@Mylittlethings_.. 2 жыл бұрын
Sir why hiv patient are more susceptible to EPTB than PTB
@altamirsofyan900
@altamirsofyan900 6 жыл бұрын
I had pleural TB on my left side,the decrease of breath noises were true,but I did'nt feel dullness.
@doc9037
@doc9037 8 жыл бұрын
fast and easy way of learning .thank u so much
@thestudyspot
@thestudyspot 8 жыл бұрын
+Reeshma Muthaleep Glad to you liked it
@maripogi7
@maripogi7 7 жыл бұрын
Congenital TB is not only passed through the placenta. It is now known to be transmitted to the fetus through the endometrium. I was born with Pott's Disease in 1946. My mother was placed in a sanitarium in 1939; that was the treatment for TB. She had a baby in 1941 which died at 2 months; then, a baby in 1942 which died at 8 months. I believe both were due to TB acquired congenitally. I did not realize I had Pott's Disease until 2006. I developed an abscess in my psoas muscle at the left groin. It was internal only. The CT Scan appeared to my ignorant doctors as if I had a tumor. They did a needle-biopsy but did not package the specimen for culture; they wanted to know where the cells in the tumor had come from. The lab stated that there was just junk in the sample, but not to discount TB. I knew of my mother's history of TB and told them so; then an "old pathologist" at Loma Linda recognized the "tumor" as a TB abscess, but he saw the film as a courtesy, not officially on my case. But my doctors wouldn't believe me and chose to ignore him. I went to Long Beach Health Dept and paid for a Quantiferon test; it was positive. But still, I was refused treatment. I went to Kaiser, test in hand, and a wonderful, brave doctor treated me; I got better. After 18 months of isoniazid and ethambutol, I was okay until I had a lumpectomy in 2013 and radiation afterward. The lump was ductile and in situ, only 1.6 cm... but the radiation set the TB free again. I have struggled since I recognized that in March, 2015. Nobody will treat me. Kaiser even told me that they had treated me erroneously in 2006; there is no money in treating EPTB and it is difficult to diagnose and it is not contagious. So just go off and die the hideous death that awaits the poor b______d in this condition. That is what I get. Americans do not have TB. This May I had a partial mastectomy on my other breast. It was a lobular invasive cancer, 3.5 cm with no lymph nodes involved. I refused radiation or chemo if no TB treatment would be done concurrently. They were on that mastectomy like white on rice and the thousands of dollars Medicare paid is why. But week after week I try to get TB treatment, and I am told someone will call to set up a consult. I wait at home the day they promise to call, but they don't call. I have brought all my images, including a nuclear medicine scan Kaiser did in 2015, which got the techs excited and they chose to do a second scan around the body because of the massive infection (their description) which they saw and they are uploaded to Loma Linda's system. My county health department has them, too, but no one cares. BUT, it was reported to me that the pathologist Kaiser hired said he saw "nothing remarkable". And, mind you, if I had not asked about the isotope, they would have used the indio which does not show squamous infections, instead of the gallium. The techs thanked me. How would you feel if YOU were treated like a pariah and left to go untreated while your body fights for your life, a battle which can only end in disaster and growing incapacity? I have lost the ability to stand upright for more than a minute or two, so I use a walker now. I can only sleep in two positions and wake if I fail to hold my arms correctly because of TB affecting my joints. I cannot carry much of anything or lift and it hurts and wears me out to put dishes on shelves at shoulder height. Yes, I am very angry. This is a stupid waste of my life when all it would take is a few 1940's anti-biotics.
@xDomglmao
@xDomglmao 5 жыл бұрын
Don't know if your story is true but hell I'll remember the fetal transmission now for my entire life for sure. How about visiting another country and ask for treatment there?
@Thailova
@Thailova 4 жыл бұрын
Go to mexico or thailand
@fahadhussain6440
@fahadhussain6440 4 жыл бұрын
Gina Mariposa its ok
@fahadhussain6440
@fahadhussain6440 4 жыл бұрын
Gina Mariposa course completed
@cabaashashi2668
@cabaashashi2668 2 жыл бұрын
Hi
@Perfect_Creation
@Perfect_Creation 4 жыл бұрын
I'm x Dr bdq survival denger seen
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