Pulmonary Tuberculosis. Clinical Picture

Pulmonary tuberculosis is caused by mycobacterium tuberculosis, which produces characteristic tuberculous changes in the lung. This disease may also affect other organs: bones, joints, lymphatic glands, kidneys, etc. The causative agent of tuberculosis was discovered by Koch in 1882.

In the early stage of tuberculosis the patient usually complains of a general malaise, fatigue, loss of appetite and body weight. Cough may be dry or productive, i.e. with sputum discharge. Coughing becomes worse at night and in the morning. In patients with cavities in the lungs coughing is accompanied by a considerable discharge of sputum.

Sputum is mucopurulent. Its microscopic examination reveals a large number of pus corpuscle, erythrocytes, and tuberculous organisms. Blood in the sputum is sometimes the first sign of tuberculosis. If large blood vessels are involved the discharge of blood may become profuse.

Fever is one of the permanent symptoms of pulmonary tuberculosis. In benign processes the body temperature is often subfebrile. In active forms it may range from 38⁰C to 39⁰C. A considerable elevation of temperature is observed in pneumonic forms, when fever persists at a level of 38⁰C and higher for several months.

Cold profuse perspiration at night is sometimes evidence of a severe form of tuberculosis. Loss of body weight is one of the typical signs of pulmonary tuberculosis. It is caused by tuberculous intoxication, a sharp increase in the metabolic rate and loss of appetite. Loss of body weight is particularly marked in progressive forms of the disease.

Task 7 Read and translate the sentences using corresponding English equivalents of the terms given in brackets:

1 It is sometimes difficult to make a correct diagnosis (на ранніх ступенях) of some diseases.

2 (Втрата апетиту) is a very important symptom, which a physician must always pay attention to.

3 (Підвищення температури) has been persisting for several months since it was a pneumonic form of tuberculosis.

4 Dullness in the lungs, accelerated respiration, dry or moist râles and crepitation may be (свідченням) of lobular pneumonia.

5 (Різке збільшення) of the number of leucocytes is often the evidence of a certain inflammatory process in the human body.

Home Assignments 3

Task 1 Use the proper tense forms to translate the sentences into English in writing:

1 При тяжких формах пневмонії температура зазвичай тримається на рівні 38⁰С.

2 Зараз у цього хворого температура 38⁰С внаслідок важкої форми пневмонії.

3 У цього хворого температура утримується на рівні 38⁰С вже протягом місяця.

4 Хворий завжди дотримувався постільного режиму при серцевих нападах.

5 Хворий дотримувався постільного режиму, коли в нього стався серцевий напад.

6 У зв’язку із захворюванням серця хворий дотримувався постільного режиму протягом трьох тижнів.

Task 2 Define the root in the terms and translate them into Ukrainian:

intoxication, allowance, changeable, clearly, uncomplicated, disappearance, remarkable, unprotective, senselessness, thickness, warmth, ineffective, enlargement.

Task 3 Form the nouns (1), the adjectives (2), the adverbs (3), the verbs (4) with the same root and translate them:

1) accomplish, accumulate, investigate, pass, perspire, present;

2) protect, effect, change, move, pain, poison, produce, response;

3) loud, exact, mild, quiet, rapid, separate, severe, sharp, smooth, sudden;

4) accomplishment, complicated, considerable, unexpected, elevation.

Task 4 Choose the right answer:

1 What forms of tuberculosis are accompanied by a subfebrile temperature?

a) benign forms of tuberculosis;

b) pneumonic forms of tuberculosis.

2 What kind of sputum has the patient with tuberculosis?

a) it is purulent; b) it is mucopurulent.

3 The evidence of what form of tuberculosis may cold profuse perspiration at night be?

a) it may be the evidence of a benign form of tuberculosis;

b) it may be the evidence of a severe form of tuberculosis.

4 What erythrocyte sedimentation rate has the patient with lobular pneumonia?

a) it is slow; b) it is accelerated.

5 What does the X-ray examination reveal in case of lobular pneumonia?

a) it reveals a marked shadowing in the lungs;

b) it reveals a cavity in the lungs.

Task 5 Fill in the blanks with “what”, “which”, “whose”, “when”:

1 … treatment is indicated if a patient has a severe form of lobular pneumonia?

2 … may the patient’s erythrocyte sedimentation rate be accelerated?

3 … of the following symptoms is characteristic of tuberculosis: a bad headache, cough with mucopurulent sputum or a coated tongue?

4 Thanks to … scientific investigations was mycobacterium tuberculosis discovered?

Task 6 Read the text using a dictionary. Learn the words in bold type. Entitle the text. Write down irregular verbs and give their basic forms. Get ready to discuss the text. Give the English equivalents of the following word combinations:

симптоми, типовiдля первинного туберкульозу; в ураженій легенi; клiнiчнiпрояви; позитивна проба; ущільнення легеневої тканини; перкуторний звук.

Primary tuberculosis usually begins in childhood and affects the lungs and bronchial lymphatic glands of the lung roots. Primary tuberculosis may not give any clinical manifestations and is revealed only by a positive Pirquet’s and Mantoux’s tests and X-ray examination. Loss of appetite, short periods of fever, slow growth, and loss of weight may be some of the symptoms characteristic of primary tuberculosis.

Physical examination sometimes reveals consolidation of the pulmonary tissue. A shorter percussion sound and a small number of dry and fine moist râles are heard in the involved lung.

A favorable course of primary tuberculosis leads to the formation of a Ghon’s focus. In unfavorable cases primary tuberculosis may lead to an extensive inflammation.