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tuberculosis

This is a mind map about tuberculosis, a chronic respiratory infectious disease caused by Mycobacterium tuberculosis that invades the human lungs.

Edited at 2024-03-13 10:55:35

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Outline

tuberculosis

Tuberculosis spreads among people

Mainly spread by droplets

Source of infection → tuberculosis patient → positive sputum smear

★Tuberculosis is acid-resistant Mycobacterium

The occurrence and development of tuberculosis in the human body

primary infection

primary tuberculosis

First inhalation of aerosol (Mycobacterium tuberculosis vs alveolar macrophages)

(Primary focus) → Mycobacterium tuberculosis survives and grows and reproduces inside and outside alveolar macrophages.

Inflammatory lesions in lung tissue

primary syndrome

Mycobacterium tuberculosis in the primary lesion follows the lymphatic drainage in the lungs → hilar lymph nodes → lymph node enlargement

★↑The combination of primary lesion and enlarged tracheobronchial lymph nodes

★↑The primary lesion continues to expand to other organs (tuberculosis)

secondary tuberculosis

Mycobacterium tuberculosis enters the human body and reproduces for the first time → the human body develops specific immunity to the bacilli

Reduce the size of primary lesions/hilar lymph nodes/calcify/stop reproduction

There are still a small number of tuberculosis that have not been eliminated, and long-term dormancy has become a source of secondary tuberculosis.

Tuberculosis Immunity and Delayed Allergy

The main immune mechanism of tuberculosis is cellular immunity

koch phenomenon

primary allergic reaction

secondary immune response

secondary tuberculosis

Secondary tuberculosis has obvious clinical symptoms (prone to cavities and excretion of bacteria) → is contagious

two ways

Tuberculosis caused by the reactivation of latent Mycobacterium tuberculosis bacteria left over from the primary tuberculosis infection period (endogenous infection)

Relapse of Mycobacterium tuberculosis infection (exogenous infection)

pathology

Classification

inflammatory exudation

hyperplasia

Degenerative lesions → Caseous necrosis

Basic pathological changes

Destruction and repair at the same time

Mainly hyperplasia manifestation → tuberculosis miliary nodules

Caseous necrosis → mostly occurs when Mycobacterium tuberculosis is highly virulent/low body resistance

Pathological changes and outcomes

Indicates worsening of the disease course → acute chestnut tuberculosis (spread through blood and lymphatic channels)

Become an endogenous source of infection → Lesion latent secondary tuberculosis

heal

clinical manifestations

symptom

respiratory symptoms

Cough/phlegm for more than two weeks/blood in the phlegm

phlegm

Cavities are formed → there is more phlegm

Combined with other bacterial infections → there may be thick sputum

Most patients have a small amount of hemoptysis (about 3/1 of the population)

Caused by telangiectasia

Very few cases of massive hemoptysis

Caused by rupture of bronchial artery/aneurysm

Difficulty breathing is seen in

caseous pneumonia

Massive pleural effusion

Tuberculosis lesions spread to the pleura → chest pain

Hemoptysis

Classification

Most patients have a small amount of hemoptysis (about 3/1 of the population)

Caused by telangiectasia

Very few cases of massive hemoptysis

Caused by rupture of bronchial artery/aneurysm

Fever after hemoptysis

Low fever (blood clot absorption)

High fever (infection)

systemic symptoms

Afternoon hot flashes/night sweats/fatigue

★★Special symptoms

A few patients may have rheumatic fever-like symptoms → nodular rheumatism

Nodular/annular erythema may be seen near affected joints

Tuberculosis diagnosis

imaging diagnosis

Chest X-ray examination (anterior/lateral chest radiography) (preferred conventional method)

Classification

Secondary

Posterior apical segment of upper lobe/dorsal segment of lower lobe/posterior basal segment

primary

Lower part of upper leaf/upper part of lower leaf

★Memory

The tuberculosis bacilli infected the person for the first time and was not sensible, so he was lazy and stayed near the bronchus, feeling that there was enough oxygen, that is to say, the lower section of the upper lobe and the upper section of the lower lobe. Later, he was cured; the second time he infected the person, he learned Be smart, go to the place farthest from the bronchus, where there is also enough oxygen, that is, where the posterior segment of the upper leaf tip is hidden.

Infiltration/proliferation/calcification can coexist → easy to form cavities

★★Confirmed

Sputum culture

Sputum Mycobacterium tuberculosis test

Sputum tuberculosis bacilli examination (whether the bacterium is excreted) → Infectious

Tuberculin/PPD/antibody test → determine whether you have been infected in the past

Erythrocyte sedimentation rate → Whether it is the active phase

Tuberculosis bacteria found in sputum (reliable basis for diagnosing pulmonary tuberculosis)

tuberculin test

Negative

4-8 weeks before tuberculosis infection (die)

Malnutrition/HIV infection/severe illness

Miliary tuberculosis (this type of tuberculosis is more serious)

★Allergy can only be established 4-8 weeks after Mycobacterium tuberculosis infection

Masculine meaning

Vaccination with BCG vaccine

Have not been vaccinated with BCG but are positive

ever infected

Infants and young children → not vaccinated → positive (most valuable for diagnosing active tuberculosis)

active tuberculosis

Negative → positive or less than 10mm → greater than 10mm

There is a new infection

Is there any mobility?

X-image performance

Have mobility

Patchy shadows with blurred edges (central dissolution, cavities, disseminated lesions)

No mobility

Calcification, induration, fibrosis, high density of lesions/clear boundaries

Tuberculosis classification

primary tuberculosis

dumbbell shadow

blood group disseminated pulmonary tuberculosis

acute miliary tuberculosis

Performance

Acute onset and persistent high fever

systemic toxaemic inflammation

Chest X-ray size/density/distribution are uniform

secondary tuberculosis

Infiltrative pulmonary tuberculosis (spotted shadow) (cloudy shadow)

Tuberculosis (calcification focus)

Caseous pneumonia (ground glass) → later cavity (worm-eaten cavity) appears

Chills and high fever/sudden onset

Frequent elimination of bacteria

Fibrous cavitary tuberculosis (the most contagious) (thick-walled cavities/lung textures like weeping willows)

Long course of disease/repeated progression and deterioration/prolonged recovery

Severe damage to lung tissue

Severely impaired lung function

★The hilum moves upward (pulled by fibers)

★Source

Primary tuberculosis bacteria have not been completely eliminated

tuberculous pleurisy

Various tuberculosis imaging diagnoses

primary tuberculosis

hilar lymphadenopathy

infiltrative pulmonary tuberculosis

Commonly seen at the apex of the upper lobe/dorsal and posterior base of the lower lobe

Blood type disseminated type (chestnut type pulmonary tuberculosis)

Uniform size/density/distribution

chronic fibrocavitary tuberculosis

Identification of various holes

thin wall cavity

cavitary tuberculosis

thick wall cavity

fiber cavity type

Cavity with liquid level

lung abscess

treat

Mycobacterium tuberculosis is divided into ABCD based on metabolic status

A bacterial group → reproduces rapidly, is large in number, and is the main part

Isoniazid

B flora → semi-quiescent

pyrazinamide

C flora → semi-quiescent

rifampicin

D flora → completely dormant

Memory:un (I) believable

in principle

Early/Regular/Full Process/Moderate/Combined

Reinforcement stage (bad guys doing evil) (HRZE)

Isoniazid Rifampicin Pyrazinamide Ethambutol

Consolidation Phase (Only Bad Guys) (HR)

Isoniazid Rifampicin

treat

drug

All bactericides

Isoniazid

rifampicin

semi-bactericidal medicine

Streptomycin

pyrazinamide

plan

consolidation therapy

prevention

Isoniazid (orally for 6 months)

Asymptomatic

Isoniazid Rifampicin

Consolidate curative effect and prevent recurrence

Symptomatic

Isoniazid Rifampin Streptomycin/Pyrazinamide

strengthen

Involves the brain

Isoniazid Rifampicin Pyrazinamide Streptomycin

Rapid sterilization

abbreviation

Rifampicin R(RFP)

Isoniazid H(INH)

Pyrazinamide Z (PZA)

Ethambutol E

Replenish

1 medicine for prevention

Asymptomatic 2 medicines

3 medicines for symptoms

4 drugs that seriously affect the brain

Replenish

Most common

infiltrative pulmonary tuberculosis

The most contagious

chronic fibrocavitary type

The sickest

caseous tuberculosis

allergy supplements

Type I allergic reaction (immediate type→anaphylaxis→IgE mediated)

Allergy/Shock/Asthma

Type 2 allergy (cytotoxicity→IgG mediated)

Rheumatism/blood-related diseases (blood transfusion, hemolysis, vascular damage)

Type III allergy (immune complex type → vasculitis type)

Rheumatoid/Hepatitis/Serum Sickness

Type IV allergic reaction (delayed type→T cell mediated)

Tuberculosis/contact dermatitis

Replenish

Thin-walled cavity Fluid level Neutrophils↑

lung abscess

Thin-walled cavity No fluid level Neutrophils—

tuberculosis