logging in or signing up TB ppt aSGuest27554 Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: Embed: Flash iPad Copy Does not support media & animations WordPress Embed Customize Embed URL: Copy Thumbnail: Copy The presentation is successfully added In Your Favorites. Views: 3092 Category: Entertainment License: All Rights Reserved Like it (1) Dislike it (0) Added: October 05, 2009 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... By: puneetraj08 (35 month(s) ago) nice Saving..... Post Reply Close Saving..... Edit Comment Close Premium member Presentation Transcript PulmonaryTuberculosis : PulmonaryTuberculosis Primary PulmonaryTuberculosis : Primary PulmonaryTuberculosis 1° Pulmonary Tuberculosis : 1° Pulmonary Tuberculosis Patterns Pneumonia Adenopathy Atelectasis Pleural effusion Primary TuberculosisPneumonia : Primary TuberculosisPneumonia Upper lobes affected slightly more than lower Pneumonia common Cavitation is rare Lobar pneumonia almost always associated with lymphadenopathy Infiltrate + ipsilateral adenopathy–think TB Primary TuberculosisAdenopathy : Primary TuberculosisAdenopathy Unilateral hilar and/or paratracheal Usually right-sided Rarely bilateral Differentiates 1° from 2°—does not occur in postprimary TB Adenopathy much more common in children Primary TuberculosisAtelectasis : Primary TuberculosisAtelectasis Classically affects anterior segments of upper lobes, or Medial segment of the RML Primary TuberculosisPleural Manisfestations : Primary TuberculosisPleural Manisfestations Effusion as a manifestation of 1° TB more common in adults than children Primary TuberculosisGeneral : Primary TuberculosisGeneral Calcification in 1° complex is relatively rare Few patients with 1° TB have clinical manifestations Postprimary Tuberculosis Reactivation TB : Postprimary Tuberculosis Reactivation TB Reactivation TBGeneral : Reactivation TBGeneral Most cases in adults occur as reactivation of 1° focus of infection acquired in childhood Caseous necrosis and tubercle are pathologic hallmarks of post 1° TB Tubercle=accumulations of mononuclear macrophages, Langhan’s giant cells surrounded by lymphocytes/fibroblasts Reactivation TBGeneral : Reactivation TBGeneral Healing occurs with fibrosis and contraction Calcification is rarer than in 1° Limited mainly to apical and posterior segments of upper lobes and superior segments of lower lobe Reactivation TBPatterns : Reactivation TBPatterns Pneumonia Cavity formation Transbronchial spread Bronchiectasis Bronchostenosis Pleural disease Tuberculoma Bone involvement Reactivation TBPatterns : Reactivation TBPatterns Affects apical or posterior segments of upper lobes or superior segments of lower lobes Bilateral upper lobe disease is very common May present as pneumonia Cavitation may result Cavity is usually thin-walled, smooth on inner margin with no air-fluid level Reactivation TBPatterns : Reactivation TBPatterns Transbronchial spread may occur—from one upper lobe to opposite lower Bronchiectasis—usually asymptomatic Bronchostenosis due to fibrosis and stricture Fibrosis may cause distortion of a bronchus and atelectasis many years after initial infection=“middle lobe syndrome” Reactivation TBPatterns : Reactivation TBPatterns Pleural effusion in postprimary TB Almost always means direct spread of disease in to pleural cavity Should be regarded as an empyema Carries a graver prognosis than effusion of 1° form Direct extension into ribs or sternoclavicular joints is uncommon Reactivation TBPatterns : Reactivation TBPatterns Solitary pulmonary nodule Tuberculoma May occur in either 1° or postprimary disease Round or oval lesions with small, discrete shadows in immediate vicinity of lesion=“satellite” lesion MiliaryTuberculosis : MiliaryTuberculosis Miliary TuberculosisGeneral : Miliary TuberculosisGeneral Hematogenous dissemination of bacilli common in 1° TB but clinically evident miliary TB rarely occurs May not manifest itself for many years after infection Miliary TuberculosisClinical : Miliary TuberculosisClinical Older men, Blacks and pregnant women susceptible Onset is insidious Fever, chills, night sweats are common Takes weeks between time of dissemination and radiographic appearance of disease Miliary TuberculosisNatural History : Miliary TuberculosisNatural History When first visible, measure about 1 mm in size Frequently missed on first films Can grow to 2-3mm if left untreated When treated, clearing is rapid Miliary TB does NOT heal with calcification Calcification in TB3 Funny Names : Calcification in TB3 Funny Names Ghon lesion=calcified granuloma Ranke complex=Ghon lesion+calcified lymph node Simon focus=healed site of 1° infection at lung apex TB and Other Diseases : TB and Other Diseases Occurs with a higher incidence in sarcoid-especially if rx with steroids Associated with silicosis Associated with HIV infection No relationship with bronchogenic Ca TB and AIDS : TB and AIDS Mycobacterium avium-intracellulare (MAI) is more common than TB TB in AIDS looks like 1° form Hilar and mediastinal adenopathy common Cavitation less common No predilection for apices TB:The Question of Activity : TB:The Question of Activity Only serial images with no change can suggest lack of activity–2 years In presence of cavities, activity must be determined clinically TuberculosisAncient Remedies : TuberculosisAncient Remedies Rest Theory “Ping-pong ball” plumbage Paraffin plumbage Oleothorax Pneumothorax and pneumoperitoneum Thoracoplasty You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.
TB ppt aSGuest27554 Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: Embed: Flash iPad Copy Does not support media & animations WordPress Embed Customize Embed URL: Copy Thumbnail: Copy The presentation is successfully added In Your Favorites. Views: 3092 Category: Entertainment License: All Rights Reserved Like it (1) Dislike it (0) Added: October 05, 2009 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... By: puneetraj08 (35 month(s) ago) nice Saving..... Post Reply Close Saving..... Edit Comment Close Premium member Presentation Transcript PulmonaryTuberculosis : PulmonaryTuberculosis Primary PulmonaryTuberculosis : Primary PulmonaryTuberculosis 1° Pulmonary Tuberculosis : 1° Pulmonary Tuberculosis Patterns Pneumonia Adenopathy Atelectasis Pleural effusion Primary TuberculosisPneumonia : Primary TuberculosisPneumonia Upper lobes affected slightly more than lower Pneumonia common Cavitation is rare Lobar pneumonia almost always associated with lymphadenopathy Infiltrate + ipsilateral adenopathy–think TB Primary TuberculosisAdenopathy : Primary TuberculosisAdenopathy Unilateral hilar and/or paratracheal Usually right-sided Rarely bilateral Differentiates 1° from 2°—does not occur in postprimary TB Adenopathy much more common in children Primary TuberculosisAtelectasis : Primary TuberculosisAtelectasis Classically affects anterior segments of upper lobes, or Medial segment of the RML Primary TuberculosisPleural Manisfestations : Primary TuberculosisPleural Manisfestations Effusion as a manifestation of 1° TB more common in adults than children Primary TuberculosisGeneral : Primary TuberculosisGeneral Calcification in 1° complex is relatively rare Few patients with 1° TB have clinical manifestations Postprimary Tuberculosis Reactivation TB : Postprimary Tuberculosis Reactivation TB Reactivation TBGeneral : Reactivation TBGeneral Most cases in adults occur as reactivation of 1° focus of infection acquired in childhood Caseous necrosis and tubercle are pathologic hallmarks of post 1° TB Tubercle=accumulations of mononuclear macrophages, Langhan’s giant cells surrounded by lymphocytes/fibroblasts Reactivation TBGeneral : Reactivation TBGeneral Healing occurs with fibrosis and contraction Calcification is rarer than in 1° Limited mainly to apical and posterior segments of upper lobes and superior segments of lower lobe Reactivation TBPatterns : Reactivation TBPatterns Pneumonia Cavity formation Transbronchial spread Bronchiectasis Bronchostenosis Pleural disease Tuberculoma Bone involvement Reactivation TBPatterns : Reactivation TBPatterns Affects apical or posterior segments of upper lobes or superior segments of lower lobes Bilateral upper lobe disease is very common May present as pneumonia Cavitation may result Cavity is usually thin-walled, smooth on inner margin with no air-fluid level Reactivation TBPatterns : Reactivation TBPatterns Transbronchial spread may occur—from one upper lobe to opposite lower Bronchiectasis—usually asymptomatic Bronchostenosis due to fibrosis and stricture Fibrosis may cause distortion of a bronchus and atelectasis many years after initial infection=“middle lobe syndrome” Reactivation TBPatterns : Reactivation TBPatterns Pleural effusion in postprimary TB Almost always means direct spread of disease in to pleural cavity Should be regarded as an empyema Carries a graver prognosis than effusion of 1° form Direct extension into ribs or sternoclavicular joints is uncommon Reactivation TBPatterns : Reactivation TBPatterns Solitary pulmonary nodule Tuberculoma May occur in either 1° or postprimary disease Round or oval lesions with small, discrete shadows in immediate vicinity of lesion=“satellite” lesion MiliaryTuberculosis : MiliaryTuberculosis Miliary TuberculosisGeneral : Miliary TuberculosisGeneral Hematogenous dissemination of bacilli common in 1° TB but clinically evident miliary TB rarely occurs May not manifest itself for many years after infection Miliary TuberculosisClinical : Miliary TuberculosisClinical Older men, Blacks and pregnant women susceptible Onset is insidious Fever, chills, night sweats are common Takes weeks between time of dissemination and radiographic appearance of disease Miliary TuberculosisNatural History : Miliary TuberculosisNatural History When first visible, measure about 1 mm in size Frequently missed on first films Can grow to 2-3mm if left untreated When treated, clearing is rapid Miliary TB does NOT heal with calcification Calcification in TB3 Funny Names : Calcification in TB3 Funny Names Ghon lesion=calcified granuloma Ranke complex=Ghon lesion+calcified lymph node Simon focus=healed site of 1° infection at lung apex TB and Other Diseases : TB and Other Diseases Occurs with a higher incidence in sarcoid-especially if rx with steroids Associated with silicosis Associated with HIV infection No relationship with bronchogenic Ca TB and AIDS : TB and AIDS Mycobacterium avium-intracellulare (MAI) is more common than TB TB in AIDS looks like 1° form Hilar and mediastinal adenopathy common Cavitation less common No predilection for apices TB:The Question of Activity : TB:The Question of Activity Only serial images with no change can suggest lack of activity–2 years In presence of cavities, activity must be determined clinically TuberculosisAncient Remedies : TuberculosisAncient Remedies Rest Theory “Ping-pong ball” plumbage Paraffin plumbage Oleothorax Pneumothorax and pneumoperitoneum Thoracoplasty