第二篇 第五章 肺结核（The second and fifth chapters are tuberculosis）.docVIP

第二篇 第五章 肺结核（The second and fifth chapters are tuberculosis） The second chapter fifth pulmonary tuberculosis.Txt Ming Sao is easy to hide, dark base to prevent. Buddha said: you two are silly, B!! The sun was born when the night was turned on the bed again Teaching aims and requirements * mastering the occurrence and development of pulmonary tuberculosis, the relationship with allergy and immunity, the key points of diagnosis and differential diagnosis, the correct use of anti tuberculosis drugs, mastering the common chemotherapy protocols and the treatment of massive hemoptysis * Familiar with the X-ray features of pulmonary tuberculosis and its relationship with pathological changes, methods and clinical importance of bacterial examination, tuberculin test, BCG vaccination Main content of teaching Summary Pathogenesis Pathology Clinical manifestation Laboratory and other tests diagnostic criteria differential diagnosis Treatment Summary Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis. The emergence and expansion of drug-resistant bacteria, HIV and the imperfect control plan have led to a marked increase in the global TB epidemic Delayed type (type IV allergy) Drug resistance Concept: solid culture medium, INH 1 mu g/ml, SM 10 mu g/ml, RFP 50 mu g/ml, still can grow tubercle bacillus, call this medicine resistant bacteria Secondary resistance to natural resistance Pathological changes Depending on the number, virulence, body resistance, and allergic response to M.tuberculosis 1. exudative lesions The lung tissue in the lesion area was congested and edematous, and there were infiltration of neutrophils, lymphocytes and monocytes, exudation of fibrin and a small amount of epithelial cells and multinucleated giant cells in the alveoli. Acid fast staining can detect tubercle bacillus. Exudative lesions, small alveolar acini, pulmonary lobule, and pulmonary segmental and lobar pneumonia tuberculosis 2. proliferative lesions (nodules) Cen