2. Path And Clinical Feat
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Transcript of 2. Path And Clinical Feat
PATHOGENESIS AND CLINICAL FEATURES OF TUBERCULOSIS
BY SURENDHAR G
histology
VARIOUS FATE OF TUBERCULOSIS
FACTORS AFFECTING NATURAL COURSE OF TB INFECTION
EVOLUTION OF TB
PRIMARY COMPLEX
Primary progressive
Disseminated or miliary
Secondary or adult type
CLINICAL FEATURES
“Spitting of pus follows the spitting of blood, consumption follows the spitting of this , and death follows consumption”
Pathology behind hemoptysisBronchial circulation-90%Pulmonary circulation-5%Submucosal plexus of arteries-terminal branches
of bronchial arteriesEndarteritis secondary to tbGrnulomas are surrounded by plethora of vessels-
become atrophic and necrosed leading to dilatation-RASMUSSEN’S ANEURYSYSMS
Post tubercular period:Post infection bronchiectasisAspergillomaBroncholith/cavernolith
signs
Extrapulmonary tb
Pleural tb
Genitourinary tb
Skeletal tb
Tuberculous meningitisoften in young children and HIVHematogenous spread or rupture of
subependymal tubercle into subarachnoid space Fever.malaise,anorexia,irritability,head
ache,mental changesMay lead to severe
headache,confusion,letharg,altered sensorium.neck rigidity
Paresis of cranial nerves,hydrocephalus,intracranial hypertension
Gastrointestinal tbSwallowing of
sputum,hematogenous,ingestion of milk from cows
Terminal ileum& caecumAb
pain,swelling,obstruction,hematochezia,massUlcerations & fistulae Tuberculous peritonitis
ab pain,fever & ascitis
Pericardial tbDirect progression of primary
focus,reactivationof latent focus or rupture of subcarinal l.nodes
elderlyFever,dyspnea,dull retrostenal
pain,pericardial frictionEffusion develops
Miliary tbUsually yellowish granulomas 1-2mm
resembling ‘millet seeds’Hepatomegaly,splenomegaly,lymphadenopat
hyChoroidal tuberclesMeningismus <10%Cryptic miliary tb &nonreactive miliary tb
WAKE UP QUESTION!!!
WHAT IS THE ROLE OF NRAMP1 POLYMORPHISM IN THE PATHOGENESIS OF TUBERCULOSIS?
NRAMP 1 PROTEIN- TRANSMEMBRANE PROTEIN IN
LYSOSOMESGENERATION OF ANTI- MICROBIAL
OXYGEN RADICALS