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Pulmonary tuberculosis
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Pulmonary tuberculosis is an infectious bacterial disease. The causative agent of the disease is Mycobacterium tuberculosis that was first identified by R. Koch in 1882. It is characterized by the formation of nodular lesions (tubercles) in the mediastinum.
In pulmonary tuberculosis the bacillus can be inhaled into the lungs where it sets up a primary tubercle and spreads to the nearest lymph nodes. Natural immune defenses may heal it at this stage. Alternatively the disease may smoulder for months or years and fluctuate with the patient’s resistance. Many people become infected but show no symptoms. Others develop a chronic infection and can transmit the bacillus by coughing and sneezing.
In the early stages of pulmonary tuberculosis the patient usually complains of general malaise, fatigue, loss of appetite and as a result loss of body weight, caused by tuberculous intoxication. The subfebrile fever persists for a long time. Then cough superadds.
Symptoms of the active form of pulmonary tuberculosis include high fever that ranges from 38° to 39°C, profuse night sweats, and cough with blood streaked sputum discharge.
Pulmonary tuberculosis is treated by various combinations of antibiotics. The treatment may last up to 6-8 months. Preventive measures must include the detection of cases by X-ray screening of vulnerable populations and vaccination with BCG vaccine of those with no immunity to the disease. Regular physical examinations are necessary as well: auscultation reveals characteristic tuberculous crackles in the lungs; palpation identifies the swollen lymph nodes in the neck or other areas. Another method of detecting pulmonary tuberculosis is a yearly Mantoux test.
Recently, there has been a resurgence of pulmonary tuberculosis in immunocompromised patients (i.e. who have HIV or AIDS). The number of patients with the disease has also increased due to patients not completing drug courses.
In some cases the bacilli spread from the lungs to the blood-stream, setting up millions of tiny tubercles throughout the body (miliary tuberculosis), or migrate to the meninges to cause tuberculous meningitis. Entering by mouth bacilli may spread to abdominal lymph nodes, leading to peritonitis, and sometimes spread to other organs, joints, and bones.
Though pulmonary tuberculosis is curable, it is a terminal disease if not treated in time. So, if a person develops any signs slightly resembling pulmonary tuberculosis, he should immediately seek help from phthisiatrician.
Exercise 6. Answer the questions:
1. What kind of disease is pulmonary tuberculosis?
2. What is pulmonary tuberculosis caused by?
3. What kind of formations is the disease characterized by?
4. How can a person become infected with pulmonary tuberculosis?
5. What are the symptoms of pulmonary tuberculosis?
6. What does the treatment of pulmonary tuberculosis consist of?
7. How can pulmonary tuberculosis be prevented?
8. What complications may pulmonary tuberculosis lead to?
Exercise 7. Match the symptoms of pulmonary TB given in English with their Ukrainian equivalents:
| 1. | subfebrile or high fever | a | втрата ваги |
| 2. | general malaise and fatigue | b | вологі хрипи у легенях |
| 3. | cough with sputum discharge | c | вузликові ураження |
| 4. | crackles in the lungs | d | субфібрильна чи висока лихоманка |
| 5. | profuse night sweats | e | кашель з виділенням мокротиння |
| 6. | nodular lesions | f | набряклі лімфатичні вузли |
| 7. | loss of body weight | g | надмірна пітливість уночі |
| 8. | swollen lymph nodes | h | загальне нездужання та втома |
Exercise 8. Match the kinds of diagnostic tools with their explanations:
| 1. | X-ray screening | a) | a method of skin testing aimed at detecting tuberculosis, named after the French physician |
| 2. | vaccination | b) | examination by touch for the purpose of diagnosing disease |
| 3. | Mantoux test | c) | the procedure during which a patient is thoroughly examined from head to toes |
| 4. | physical examination | d) | the laboratory analysis of specimen taken from the patient for culturing the Mycobacterium tuberculosis organisms |
| 5. | auscultation | e) | laboratory examination of physical / chemical properties and the number of erythrocytes, leukocytes, etc. |
| 6. | palpation | f) | process of giving injections of a killed microbe in order to stimulate the immune system against it, thus, preventing disease |
| 7. | blood analysis | g) | the act of listening, either directly or through a stethoscope or other instrument, to sounds within the body as a method of diagnosis |
| 8. | sputum analysis | h) | a radiographic image of the body internal organs and structures, usually used for diagnostic purposes |
Exercise 9. Find the synonyms in the text to the words and word-combinations given below:
| therapy – | moist rales – |
| inoculation – | excessive perspiration – |
| check-up – | productive cough – |
| tubercles – | cause of disease – |
Exercise 10. Re-write the sentences translating the words and word-combinations in italics:
1. Регулярні медичні огляди must be carried out twice a year.
2. Кашель з виділення мокротиння is called productive cough.
3. During the check-up the physician heard вологі хрипи in the patient’s lungs.
4. Pulmonary tuberculosis is a смертельне захворювання, if not treated in time.
5. It is difficult to make a correct diagnosis на ранніх стадіях of some diseases.
6. People with туберкульозом легенів suffer from втрати ваги caused by tuberculous intoxication.
7. Втрата апетиту is a very important symptom, which a physician must always pay particular attention to.
8. There are a lot of бактеріальних інфекційних хвороб such as scarlet fever, whooping cough, tetanus, diphtheria, etc.
Exercise 11. Insert the necessary preposition:
| at; by; due to; in (2); to (2); of |
1. In pulmonary tuberculosis there are a lot of nodular lesions … the mediastinum.
2. Yesterday the patient complained … general malaise, slight fatigue and headaches.
3. Profuse sweats … night serve the grave sign of pulmonary tuberculosis.
4. Swollen lymph nodes … the neck indicated the presence of infection in the body.
5. People having no immunity … diseases often suffer from various infections.
6. TB spreads throughout the world … … patients not completing drug courses.
7. People with pulmonary TB can transmit it … coughing and sneezing.
8. The bacilli of pulmonary TB can migrate … the meninges and cause tuberculous meningitis.
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