1. Anatomy
    2. 1. Thoracic cage
    2. Respiratory muscles and Movements
    3. External Nose and Nasal cavity
    4. Paranasal Air Sinuses
    5. Pharynx
    6. Larynx
    7. Trachea
    8. Brochopulmonary segments
    9. Pleura
    10. Lung
    11. Diaphragm
    12. Histology (Epiglottis, Trachea and Lungs)
  2. Biochemistry
    3. 13. Metabolism in the Lungs
    14. Synthesis of Surfactant system in Lungs
    15. Hyaline Membrane Disease (Infant Respiratory Distress Syndrome)
    16. Gaseous Transport and Haemoglobin
    17. Ion Electrolyte Balance
    18. Henderson Hasselbalch Equation
    19. Anion Gap (AG)
    20. Biological Oxidation
    21. Electrolyte Transport Chain
  3. Microbiology
    4. 22. Streptococcus pyogenes
    23. Corynebacterium diphtheria
    24. Streptococcus pneumonia
    25. Haemophilus influenzae
    26. Pseudomonas aeruginosa
    27. Microbacterium tuberculosis
    28. Bordetella pertussis
    29. Whooping cough
    30. Viruses
    31. Orthomyxo viruses
    32. Paramyxoviruses
    33. Respiratory Syncytial Virus (RSV)
    34. Adenovirus
    35. Rhinovirus
    36. Severe Acute Respiratory Syndrome (SARS)
    37. Histoplasma Capsulatum
    38. Aspergillus
    39. Cryptococcus neoformans
    40. Pneumocystis carinii
    41. Parasites
    42. Paragonimus westermani
  4. Pathology
    5. 43. Atelectasis
    44. Tuberculosis
    45. Chronic Obstructive Pulmonary Disease
    46. Emphysema
    47. Bronchial Asthma
    48. Bronchiectasis
    49. Acute Respiratory Distress Syndrome
    50. Hyaline Membrane Disease
    51. Pneumonia
    52. Pneumoconiosis
    53. Bronchogenic Carcinoma
    54. Pleural Lesions
  5. Pharmacology
    6. 55. Antitussives, Expectorants and Mucolytics or Therapy of Cough
    56. Drugs used in Bronchial Asthema
    57. Nasal Decongestants and Cold remedies or Therapy of Allergic Rhinitis
    58. Chemotherapy of Tuberculosis
  6. Physiology
    7. 59. Mechanism and Mechanics of Breathing
    60. Regulation of Respiration
    61. Pulmonary circulation
    62. Pulmonary Gas exchange
    63. Gas transport and Exchange
    64. Lung compliance
    65. Pulmonary Function Tests
    66. Spirometry
    67. Applied Respiratory Physiology
    68. Abnormal Breathing
    69. Artificial Respiration
    70. Lung Defense Mechanism
Microbiology
27. Microbacterium tuberculosis
INTRODUCTION
HISTORY
VIRULENCE FACTORS
PATHOGENESIS
CLINICAL MANIFESTATION
LABORATORY DIAGNOSIS
Specimen collection
Two sputum sample
Spot sample
Collected on the same day under supervision
Early morning sample
Collected on the next day in empty stomach, after rinsing the mouth well
Alternatively 2 spot samples at least one hour apart should be collected.
Precaution
Sputum collection booths
  1. Located away from other people
  2. Outside in well ventilated space
Quality
  1. Patient should be advised to spit the sputum deeply from the chest by inhaling deeply.
  2. Sputum should be at least 3-5ml in quantity.
  3. Thick and purulent (yellowish mucus).
  4. Salivary specimens appearing watery should be discarded.
Colleting container
  1. Clean tube
  2. Wide mouthed
  3. Tightly screw capped
Digestion, Decontamination and Concentration
Modified Petroff's method (4% NaOH)
NALC (N-acetyl-L-cysteine) + 2% NaOH
Direct smear microscopy
Acid fast stain
Ziehl-Neelsen (ZN) technique
Interpretation
Negative result
At least 100 oil immersion fields should be examined for 10-15 minutes before giving a negative report.
Positive result
M. tuberculosis appears as long slender, beaded, less uniformly stained red colored acid-fast bacilli (AFB).
Kinyoun's Cold Acid-fast staining
    It differs from ZN stain in that
  1. Heating is not required
  2. Phenol concentration in carbol fuchsin is increased.
  3. Duration of carbol fuchsin staining is more.
Fluorescence staining
Bacilli appearance
Brillant yellow against the dark background.
Culture
Culture medium
Basal media
Enriched media
Blood agar
Selective media
Lowenstein-Jensen Medium
  1. Rough, Touch and Buff-colored colonies
Automated Liquid Culture
About
  1. It monitors the growth continuously and offer a faster turnaround time compared to conventional culture.
BACTEC MGIT (Mycobacterial Growth Indicator Tube)
Culture smear microscopy
Gram stain
Hanging drops
Identification
Biochemical tests
Niacin test
Rabbit pathogenicity tests
It was used in past.
Automation tests
VITEK
MALDI-TOF
Molecular methods
PCR
Automated Real Time PCR
Cartilage-based nucleic acid amplification test (CBNAAT)
GeneXpert (CBNAAT)
Chip-based real-time PCR
Truenat
PROPHYLAXIS
TREATMENT