[1] Tuberculosis Flashcards
Usual route of entry of TB Infection
Inhalation
Can you get TB from food?
Yes, it is rare but it can be obtained especially in infants who consume unpasteurized milk
In Prenatal TB, what is the first organ affected?
Liver
Undergoes enlargement and caseation necrosis
Best tissue/specimen to check for prenatal TB
Placenta, but it is hard to obtain so 2nd best would be the child’s liver
[T/F] Tuberculin tests are useful to confirm TB in children 2 weeks and younger
F
It would rarely be positive due to anergy since the immune system is not fully developed yet
Primary Prophylaxis for TB
Isoniazid / Rifampicin
Most common extrapulmonary site of TB in children
Lymphatics (67%)
5 Criteria of TB Stages in Children
- Exposure to adult/adolescent with active disease
- Positive Mantoux tuberculin test
- S/Sx suggestive of TB
- CXR suggestive of TB
- Lab findings suggestive of TB
Which criteria must a child have to be classified as Class I TB Stage?
Exposure to adult/adolescent with active disease
Which criteria must a child have to be classified as Class II TB Stage?
- Exposure to adult/adolescent with active disease
2. Positive Mantoux tuberculin test
Which criteria must a child have to be classified as Class III TB Stage?
3/5 criteria
[T/F] Absence of hemoptysis is useful in concluding no TB in children
F, children usually have TB with no hemoptysis
Is hilar adenopathy on CXR a sensitive/specific indicator of disease?
No, because even if it has a sensitivity of 83% specificity is only 36% for TB, therefore it is not an adequate basis for treatment
[Management of Tuberculosis]
Child lives in settings where the prevalence of the
HIV is high or where resistance to isoniazid is high, or both, with suspected or confirmed PTB or peripheral lymphadenitis
HRZE 2 HR 4
[Management of Tuberculosis]
Children who are HIV Negative
HRZ 2 HR 4
[Management of Tuberculosis]
Children with suspected or confirmed PTB or
tuberculous peripheral lymphadenitis who live in settings with low HIV prevalence or low resistance to isoniazid
HRZ 2 HR 4
[Management of Tuberculosis]
Child has extensive pulmonary disease living in settings of low HIV prevalence or low isoniazid resistance
HRZE 2 HR 4
[Management of Tuberculosis]
Children who are suspected or confirmed with TB Meningitis
HRZE 2 HR 10 for 12 Months
[Management of Tuberculosis]
Children with proven or suspected PTB or TB Meningitis caused by MDR-TB
Fluoroquinolone along with a normal regimen
[Treatment Modality According to Stage of Condition]
Exposure
H x 3 months and repeat PPD; if positive, extend to 9 months
[Treatment Modality According to Stage of Condition]
Infection
H x 9 months
[Treatment Modality According to Extent of Disease]
Pulmonary
HRZ x 2 months + HR x 4 months
[Treatment Modality According to Stage of Condition]
Extrapulmonary
6 months: Non-life threatening form
9 months: Bone and Joint TB
12 months: TB Meningitis
