1. What do you mind Pulomologi Tuberculosis ?

Answer :
Pulmonary tuberculosis (TB) is an infectious disease caused by the bacillus Mycobacterium
tuberculosis (M. tuberculosis), which most commonly affects the lungs (pulmonary TB) and
spreads when people with pulmonary TB expel the bacteria into the air [1, 2]. TB can lie dormant
in individuals for decades and may be reactivated later, leading to widespread systemic
symptoms [3]. This infectious disease is among the 10 leading causes of death worldwide,
ranking above HIV/AIDS [4, 5]. In 2015, the World Health Organization (WHO) approved the
ambitious post-2015 global “End TB Strategy” [6] with a goal of reducing TB incidence by 90%
and TB deaths by 95% by 2035 [7]. To end the global TB epidemic, improved diagnostic tools
and treatment as well as effective surveillance targeting the vulnerable populations are
imperative.

2. So,Do you mind ……… xray not specific pulmonary tuberculosis radiology
examination
3. How covid you diagnosis in the ……..area ……the examination
4. What kind of the drug to the tuberculosis drug can cause damage of the
kidney
5. Refrotoksis can the impact from the drug tuberculosis can make acute or
cronic

1. What the unic characteristic of the mycobacterium tuberculosis?

Screen patients for TB if they have a history of persistent cough for more than 2 weeks and a
history of possible TB exposure; recent travel in an endemic area; and symptoms of fever, night
sweats, unintentional weight loss, shortness of breath, hemoptysis, or chest pain. 1,5 If the primary
lesion is large, bacteria can infiltrate the pleural space, causing pleural effusion. Physical
examination findings include dullness to percussion and decreased breath sounds in the affected
area.6 Finger clubbing, a late sign, is associated with poor oxygenation. Wasting (loss of body fat
and lean tissue) is the result of the inflammatory and immune response. 6 Radiologic
abnormalities include hilar or paratracheal adenopathy and cavitary or upper lobe infiltrates. 1
2. In the patogent of tuberculosis can you explain?
As is true for most infectious diseases, the clinical manifestations of mycobacterial infections
represent a complex interaction between pathogen and host. Different clinical forms of leprosy,
for example, seem to be determined by the nature of the T-cell responses mounted by the
patient. Modlin et al showed several years ago that so-called resistant, paucibacillary lesions
were characterized by T lymphocytes that produced mainly interleukin 2 and interferon γ,
whereas susceptible, multibacillary lesions featured a cytokine profile marked by lymphocytes
that produced interleukin 4, interleukin 5, and interleukin 10 [1]. Pulmonary tuberculosis in
patients with advanced, cavitary disease is associated with lower production of canonical T-
helper type 1 cytokines, whereas interferon γ is present in abundance in patients with
radiographically less severe disease [2].
3. You can explain the active of the pirazinamid and ethambutol?
a. Etambutol

The anti-TB activity of ethambutol (figure 33) was reported

the first time in 1961. Ethambutol kills
active bacilli that are multiplying and havevery weak sterilization activity. This
medicine is just a littlerole in shortening the treatment time. The main
functionEMB is to prevent the emergence of resistance toother drugs in
combination therapy. Ethambutol is effective against microorganisms of the genus
Mycobacterium. Almost all strains of M. tuberculosis and M. kansasii and a
number of strains of M.minimum pharmacophore, branching and dangerous link
More alkaline nitrogenliked Branching and stereochemistry on carbon very
important for activity in cases where substitution is symmetrical
b. Pirazinamid

Pyrazinamide is considered species specific

mycobacteria and carry out characteristics
antibacterial under specific conditions (acidic pH). M.
bovis and M. leprae are intrinsically resistant to
PZA. PZAase is widely distributed in
bacteria but the efficacy of PZA against M. tuberculosis
and some other organisms are limited. All strains
Bovine mycobacteria lack PZAase activity
due to a point mutation in the pncA gene, a gene
encoding the enzyme pyrazinamide (PZAse). M.
smegmatis is also resistant to PZA, possibly
because the efflux system is so efficient that it doesn't
accumulation of POA in the cells

4. Farmakokinetik and farmakologi of the drug treatment

1. You patient have investigation of the HIV

2. How about the mechanism HIV Transmition in child?
3. What can ceftriaxone and gentamicin in your case which you fine?
4. What can the side effect of gentamicin
5. What is the side effet ……. Of the ceftriaxone and gentamicin
6. What type of immunisation your must carefull when you give ceftriaxone
7. How about booster of measles
8. How Long you ……give the antibiotik