Page 1 of 1: MEDICINE-INFECTION - TUBERCULOSIS EXACERBATED BY:

jayanta · Credits: 35983 My Scrapbook My Reading List 45 Books

TUBERCULOSIS EXACERBATED BY:
1.GASTRECTOMY.
2. ALCOHOLISM.
3.DIABETES.
4.ALL OF THE ABOVE.
ANSWER IS [4].
BUT HOW GASTRECTOMY CAN EXACERBATE T.B.?
THANK U.

drjanak · Credits: 3151 My Scrapbook

Harrison's Internal Medicine >17th Ed> Chapter 158. Tuberculosis
From Infection to Disease

Unlike the risk of acquiring infection with M. tuberculosis, the risk of developing disease after being infected depends largely on endogenous factors, such as the individual's innate immunologic and nonimmunologic defenses and level of function of cell-mediated immunity (CMI).
A variety of diseases and conditions favor the development of active tuberculosis (Table 158-1).

Table 158-1 Risk Factors for Active Tuberculosis among Persons Who Have Been Infected with Tubercle Bacilli

Factor Relative Risk/Odds (Old infection = 1)
Recent infection (<1 year) 12.9
Fibrotic lesions (spontaneously healed) 2–20
Comorbidity
HIV infection 100
Silicosis 30
Chronic renal failure/hemodialysis 10–25
Diabetes 2–4
Intravenous drug use 10–30
Immunosuppressive treatment 10
Gastrectomy 2–5
Jejunoileal bypass 30–60
Posttransplantation period (renal, cardiac)20–70
Malnutrition and severe underweight 2

(The above table has two columns - factors and relative risk with old infection having relative risk of 1. But whilst posting the table gets distorted, so sorry about that)

The most potent risk factor for tuberculosis among infected individuals is clearly HIV co-infection, which suppresses cellular immunity. The risk that latent M. tuberculosis infection will proceed to active disease is directly related to the patient's degree of immunosuppression.

The_Druid · Credits: 3298 My Scrapbook

Gastrectomy may lead to malnutrition and thus predisposes to reactivation of TB!

jayanta · Credits: 35983 My Scrapbook My Reading List 45 Books

AS ALWAYS IT'S GREAT JANAK.
REGARDS.
THANKS FOR DETAILING.
JUST KEEP IT UP.

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