Pulmonary Tuberculosis – Causes, Symptoms, and Treatment

Active disease and latent infection are different

Active pulmonary tuberculosis can release bacteria into the air when an infectious person coughs, speaks or sings. Latent tuberculosis infection does not cause active-disease symptoms and does not spread to other people. This distinction matters when interpreting a positive infection test.

Treatment duration is selected for the individual and the type of tuberculosis. CDC describes 4-, 6- and 9-month regimens for eligible cases of drug-susceptible active disease in the United States; drug resistance and other clinical factors can require different plans. The exam principle is combination therapy with completion of the prescribed course, rather than one universal duration.

 

Pulmonary Tuberculosis – Notes

Definition:
Pulmonary tuberculosis (TB) is a chronic infection of the lungs caused by the bacterium Mycobacterium tuberculosis. It damages lung tissue, including alveoli, and can lead to respiratory failure in advanced stages.

Causes:

• Infection by Mycobacterium tuberculosis
• potentially infectious when disease is active; spreads via coughs or sneezes

Symptoms:

• Persistent cough, sometimes with blood
• Intermittent fever, usually in the evening
• Night sweats
• Weight loss and loss of appetite (anorexia)
• Fatigue and weakness
• Depression
• Chest pain (due to inflammation of pleura)
• Dry cough

Complications:

• Formation of cavities or holes in lung tissue
• Respiratory failure in advanced cases

Treatment:

• Long-term use of multiple antibiotics (duration depends on the prescribed regimen)
• Strict adherence to medication schedule is crucial to prevent drug resistance

Key Facts:

• Pulmonary TB is potentially infectious when disease is active.
• Early diagnosis and treatment are essential to prevent severe lung damage and transmission.

Pulmonary Tuberculosis MCQs with Answers & Explanations

1. Pulmonary tuberculosis is caused by which bacterium?
   (a) Streptococcus pneumoniae
   (b) Mycobacterium tuberculosis
   (c) Staphylococcus aureus
   (d) Escherichia coli

Answer: (b) Mycobacterium tuberculosis
Explanation: Pulmonary TB is caused by Mycobacterium tuberculosis, which primarily affects the lungs.

2. Pulmonary TB primarily affects which part of the body?
   (a) Kidneys
   (b) Lungs
   (c) Liver
   (d) Skin

Answer: (b) Lungs
Explanation: Pulmonary TB refers specifically to tuberculosis of the lungs.

3. How is pulmonary TB transmitted?
   (a) Contaminated food
   (b) Direct skin contact
   (c) Inhaled airborne particles from someone with infectious active pulmonary TB
   (d) Water

Answer: (c) Inhaled airborne particles from someone with infectious active pulmonary TB
Explanation: TB bacteria spread through the air when an infected person coughs or sneezes.

4. Which of the following is a common symptom of pulmonary TB?
   (a) Headache
   (b) Night sweats
   (c) Rash
   (d) Nausea

Answer: (b) Night sweats
Explanation: Night sweats, along with cough and fever, are classic symptoms of TB.

5. Pulmonary TB can lead to which severe complication in advanced stages?
   (a) Heart failure
   (b) Respiratory failure
   (c) Liver cirrhosis
   (d) Kidney stones

Answer: (b) Respiratory failure
Explanation: Extensive alveolar damage can prevent sufficient oxygen intake, leading to respiratory failure.

6. Which symptom indicates blood in the lungs due to TB?
   (a) Chest pain
   (b) Hemoptysis (coughing blood)
   (c) Shortness of breath
   (d) Night sweats

Answer: (b) Hemoptysis (coughing blood)
Explanation: TB can cause inflammation and damage to alveoli, resulting in blood in sputum.

7. Treatment of pulmonary TB usually requires:
   (a) Single antibiotic for 1 week
   (b) Multiple antibiotics over several months
   (c) Painkillers only
   (d) Surgery only

Answer: (b) Multiple antibiotics over several months
Explanation: TB requires long-term combination antibiotic therapy (duration depends on the regimen) to prevent drug resistance.

8. Pulmonary TB symptoms may include:
   (a) Weight loss and anorexia
   (b) Night sweats
   (c) Persistent cough
   (d) All of the above

Answer: (d) All of the above
Explanation: These are all classic symptoms of pulmonary tuberculosis.

9. Chest pain in TB patients is usually caused by:
   (a) Heart attack
   (b) Inflammation of the pleura
   (c) Muscle strain
   (d) Gastric reflux

Answer: (b) Inflammation of the pleura
Explanation: TB causes pleuritis (inflammation of the pleura), leading to chest pain.

10. Why is pulmonary TB considered potentially infectious when disease is active?
    (a) Because it spreads through water
    (b) Because it spreads through food
    (c) Because it spreads via airborne particles
    (d) Because it spreads through touch

Answer: (c) Because it spreads via airborne particles
Explanation: TB bacteria can remain suspended in the air and infect others when inhaled.

Short Questions – Pulmonary Tuberculosis

1. Define pulmonary tuberculosis.
   Answer: Chronic lung infection caused by Mycobacterium tuberculosis, damaging alveoli and causing respiratory issues.

2. How is pulmonary TB transmitted?
   Answer: By inhaling airborne particles released by someone with infectious active disease of the lungs or throat.

3. Name three common symptoms of pulmonary TB.
   Answer: Persistent cough (sometimes with blood), night sweats, weight loss.

4. What is hemoptysis?
   Answer: Coughing up blood, a symptom of TB.

5. Why is TB considered potentially infectious when disease is active?
   Answer: Because it spreads via airborne particles.

6. Which part of the body does pulmonary TB primarily affect?
   Answer: The lungs.

7. Name one complication of untreated pulmonary TB.
   Answer: Respiratory failure.

8. How long is typical TB antibiotic treatment?
   Answer: Several months (duration depends on the prescribed regimen) with multiple antibiotics.

9. What causes chest pain in TB patients?
   Answer: Inflammation of the pleura (pleuritis).

10. Name one preventive measure for pulmonary TB.
    Answer: Early diagnosis and adherence to TB treatment; vaccination (BCG) can help prevent severe cases.

Long Questions – Pulmonary Tuberculosis

1. Explain pulmonary tuberculosis, including its causes, symptoms, and treatment.

2. Discuss how Mycobacterium tuberculosis infects the lungs and the effect it has on alveoli and lung function.

3. Describe the complications that may arise if pulmonary TB is left untreated, including respiratory failure.

4. Explain why pulmonary TB is considered potentially infectious when disease is active and how it spreads between individuals.

5. Discuss the role of long-term antibiotic therapy in the treatment of pulmonary TB and the importance of completing the full course.

6. Compare acute respiratory infections like pneumonia with chronic infections like pulmonary TB in terms of symptoms, duration, and treatment.

7. Explain the significance of symptoms such as night sweats, weight loss, and hemoptysis in diagnosing pulmonary TB.

References

• CDC: Tuberculosis transmission
• CDC: Inactive tuberculosis
• CDC: Clinical overview and treatment regimens

Frequently asked questions

Can latent tuberculosis spread to other people?

No. Latent, or inactive, tuberculosis infection is not infectious. Active disease involving the lungs or throat can spread through the air.

Does tuberculosis always need six months of treatment?

No. Duration depends on the regimen and the clinical situation. Some eligible cases of drug-susceptible active disease have shorter regimens, while other cases need longer treatment.

Can tuberculosis spread when someone speaks?

Yes. A person with infectious active tuberculosis of the lungs or throat can release bacteria into the air while speaking or singing, as well as coughing.