2. Path And Clinical Feat

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2. Path And Clinical Feat

  1. 1. PATHOGENESIS AND CLINICAL FEATURES OF TUBERCULOSIS <ul><li>BY </li></ul><ul><li>SURENDHAR G </li></ul>
  2. 10. histology
  3. 12. VARIOUS FATE OF TUBERCULOSIS
  4. 13. FACTORS AFFECTING NATURAL COURSE OF TB INFECTION
  5. 14. EVOLUTION OF TB
  6. 15. PRIMARY COMPLEX
  7. 17. Primary progressive
  8. 18. Disseminated or miliary
  9. 19. Secondary or adult type
  10. 20. CLINICAL FEATURES
  11. 23. <ul><li>“ Spitting of pus follows the spitting of blood, consumption follows the spitting of this , and death follows consumption” </li></ul>
  12. 24. Pathology behind hemoptysis <ul><li>Bronchial circulation-90% </li></ul><ul><li>Pulmonary circulation-5% </li></ul><ul><li>Submucosal plexus of arteries-terminal branches of bronchial arteries </li></ul><ul><li>Endarteritis secondary to tb </li></ul><ul><li>Grnulomas are surrounded by plethora of vessels-become atrophic and necrosed leading to dilatation-RASMUSSEN’S ANEURYSYSMS </li></ul><ul><li>Post tubercular period: </li></ul><ul><ul><li>Post infection bronchiectasis </li></ul></ul><ul><ul><li>Aspergilloma </li></ul></ul><ul><ul><li>Broncholith/cavernolith </li></ul></ul>
  13. 25. signs
  14. 26. Extrapulmonary tb
  15. 27. Pleural tb
  16. 28. Genitourinary tb
  17. 30. Skeletal tb
  18. 32. Tuberculous meningitis <ul><li>often in young children and HIV </li></ul><ul><li>Hematogenous spread or rupture of subependymal tubercle into subarachnoid space </li></ul><ul><li>Fever.malaise,anorexia,irritability,head ache,mental changes </li></ul><ul><li>May lead to severe headache,confusion,letharg,altered sensorium.neck rigidity </li></ul><ul><li>Paresis of cranial nerves,hydrocephalus,intracranial hypertension </li></ul>
  19. 36. Gastrointestinal tb <ul><li>Swallowing of sputum,hematogenous,ingestion of milk from cows </li></ul><ul><li>Terminal ileum& caecum </li></ul><ul><li>Ab pain,swelling,obstruction,hematochezia,mass </li></ul><ul><li>Ulcerations & fistulae </li></ul><ul><li>Tuberculous peritonitis </li></ul><ul><li>ab pain,fever & ascitis </li></ul>
  20. 38. Pericardial tb <ul><li>Direct progression of primary focus,reactivationof latent focus or rupture of subcarinal l.nodes </li></ul><ul><li>elderly </li></ul><ul><li>Fever,dyspnea,dull retrostenal pain,pericardial friction </li></ul><ul><li>Effusion develops </li></ul>
  21. 40. Miliary tb <ul><li>Usually yellowish granulomas 1-2mm resembling ‘millet seeds’ </li></ul><ul><li>Hepatomegaly,splenomegaly,lymphadenopathy </li></ul><ul><li>Choroidal tubercles </li></ul><ul><li>Meningismus <10% </li></ul><ul><li>Cryptic miliary tb &nonreactive miliary tb </li></ul>
  22. 42. WAKE UP QUESTION!!! WHAT IS THE ROLE OF NRAMP1 POLYMORPHISM IN THE PATHOGENESIS OF TUBERCULOSIS?
  23. 43. NRAMP 1 PROTEIN- TRANSMEMBRANE PROTEIN IN LYSOSOMES GENERATION OF ANTI- MICROBIAL OXYGEN RADICALS

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