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By MR.RAGAVENDRAN
MEDICAL HISTORY
MICROBIOLOGICAL EXAMINTION  SPUTUM COLLECTION
SLIDE PREPARATION Ziehl-Neelsen staining
MICROSCOPIC VIEW OF    M .tuberculosis
CRITERIA FOR TUBERCULOSIS DIAGNOSIS NO OF BACILLI NO OF OIL IMMERSION FIELDS SEEN RESULT 0 100 0 1-9 100 scanty 10-99 100 ...
CLASSIFICATION OF PATIENTS SMEAR POSITIVE INDETERMINATE SMEAR NEGATIVE
FALSE POSITVE <ul><li>Red stain retained by scratches in slide </li></ul><ul><li>Accidental transfer </li></ul><ul><li>Con...
FALSE NEGATIVE <ul><li>PROBLEMS IN  </li></ul><ul><li>1) collecting  </li></ul><ul><li>2) processing </li></ul><ul><li>3) ...
FLUORESCENT MICROSCOPY rhodamine auramine
WITH ACRIDINE ORANGE DYE
CULTURE solid medium <ul><li>A SLOW GROWING NONPIGMENTED , NIACIN POSITIVE ACID FAST BACILLUS is taken as M.tuberculosis <...
CULTURE liquid medium
PCR <ul><li>Commonly used target for detection of M.tuberculosis is the insertion  sequence IS6110 </li></ul><ul><li>USES ...
CHEST X RAY
LUL CAVITY
Conslidation of  RUL
PLEURAL EFFUSION right side
MASS MINIATURE RADIOGRAPHY abreugraphy
 
MANTOUX TEST
 
FALSE POSITIVE <ul><li>ATYPICAL MYCOBACTERIA </li></ul><ul><li>BCG VACCINE </li></ul>
FALSE NEGATIVE
DIAGNOSIS OF TUBERCULOUS MENIGITIS
DIAGNOSIS OF MILIARY TUBERCULOSIS <ul><li>Bone marrow biopsy </li></ul><ul><li>Liver biopsy </li></ul><ul><li>Blood  </li>...
MILIARY TUBERCULOSIS interstitial nodules of uniform size and sharp edges
CT SCAN FOR MILIARY TB
RENAL TUBERCULOSIS <ul><li>STERILE PYURIA </li></ul><ul><li>SONOGRAM </li></ul><ul><li>CALCIFICATIONS IN THE RENAL PELVIS ...
POTT’S DISEASE
Tb lymph node
 
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3. Diagnosis

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Transcript of "3. Diagnosis"

  1. 1. By MR.RAGAVENDRAN
  2. 2. MEDICAL HISTORY
  3. 3. MICROBIOLOGICAL EXAMINTION SPUTUM COLLECTION
  4. 4. SLIDE PREPARATION Ziehl-Neelsen staining
  5. 5. MICROSCOPIC VIEW OF M .tuberculosis
  6. 6. CRITERIA FOR TUBERCULOSIS DIAGNOSIS NO OF BACILLI NO OF OIL IMMERSION FIELDS SEEN RESULT 0 100 0 1-9 100 scanty 10-99 100 1+ 1-10 1 2+ >10 1 3+
  7. 7. CLASSIFICATION OF PATIENTS SMEAR POSITIVE INDETERMINATE SMEAR NEGATIVE
  8. 8. FALSE POSITVE <ul><li>Red stain retained by scratches in slide </li></ul><ul><li>Accidental transfer </li></ul><ul><li>Contaminaton from environmental mycobacteria </li></ul>
  9. 9. FALSE NEGATIVE <ul><li>PROBLEMS IN </li></ul><ul><li>1) collecting </li></ul><ul><li>2) processing </li></ul><ul><li>3) interpreting </li></ul><ul><li>4) administrative errors </li></ul>
  10. 10. FLUORESCENT MICROSCOPY rhodamine auramine
  11. 11. WITH ACRIDINE ORANGE DYE
  12. 12. CULTURE solid medium <ul><li>A SLOW GROWING NONPIGMENTED , NIACIN POSITIVE ACID FAST BACILLUS is taken as M.tuberculosis </li></ul>
  13. 13. CULTURE liquid medium
  14. 14. PCR <ul><li>Commonly used target for detection of M.tuberculosis is the insertion sequence IS6110 </li></ul><ul><li>USES </li></ul><ul><li>1)verify diagnosis by microscopy </li></ul><ul><li>2)identify genetic modifications associated with resistance </li></ul>
  15. 15. CHEST X RAY
  16. 16. LUL CAVITY
  17. 17. Conslidation of RUL
  18. 18. PLEURAL EFFUSION right side
  19. 19. MASS MINIATURE RADIOGRAPHY abreugraphy
  20. 21. MANTOUX TEST
  21. 23. FALSE POSITIVE <ul><li>ATYPICAL MYCOBACTERIA </li></ul><ul><li>BCG VACCINE </li></ul>
  22. 24. FALSE NEGATIVE
  23. 25. DIAGNOSIS OF TUBERCULOUS MENIGITIS
  24. 26. DIAGNOSIS OF MILIARY TUBERCULOSIS <ul><li>Bone marrow biopsy </li></ul><ul><li>Liver biopsy </li></ul><ul><li>Blood </li></ul><ul><li>Pus from tuberculous abscess </li></ul>
  25. 27. MILIARY TUBERCULOSIS interstitial nodules of uniform size and sharp edges
  26. 28. CT SCAN FOR MILIARY TB
  27. 29. RENAL TUBERCULOSIS <ul><li>STERILE PYURIA </li></ul><ul><li>SONOGRAM </li></ul><ul><li>CALCIFICATIONS IN THE RENAL PELVIS </li></ul>
  28. 30. POTT’S DISEASE
  29. 31. Tb lymph node
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