Tuesday, July 04, 2006

Tuberculosis in MRCP

Tuberculosis is one of the popular MRCP questions. It is caused by Mycobacterium tubeculosis and in 1993, WHO declared TB as a global emergency. It was discovered by Robert Koch in 1905.to learn more about Robert Koch, click here !
Common questions asked in MRCP are about the treatment of tuberculosis and its side effects, first line medications for TB and their side effects are as follow,

a) Isoniazid- peripheral neuropathy, hepatitis, pyridoxine deficiency, agranulocytosis, drug-induced lupus!
b) Rifampicin-cholestatic jaundice, orange urine, thrombocytopenia, enzyme inducer ( make OCP less effective).
c) Ethambutol-optic neuritis ( yellow/green colour defect)
d)Pyrazinamide-hepatitis, hyperuricaemia ( causes gout)
e) Streptomycin-ototoxicity and nephrotoxicity.

Duration of treatment usually 6 months for pulmonary TB and more than 6 months for extra-pulmonary. ( Regime usually consists of 2 months intensive daily treatment and 4 months or more for biweekly maintenance treatment)

Questions about co-infection of HIV and TB are becoming more and more popular and challenging in MRCP. I would talk abou this in future posts!

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