Oxygenation: TB Flashcards
1
Q
TB
A
- chronic, recurrent, infectious disease
- mycobacterium tuberculosis
- major public health concern early 20th century
- remains prevalent worldwide
- rare in US except in high-risk populations
2
Q
TB aka..
A
white man’s plague
3
Q
How to get TB…
A
- TB bacilli enter the lungs via droplet
- engulfed by macrophages, replicate within 2-3 weeks
- 95% of the time, macrophages isolate the bacteria, form tubercle
- TB bacteria remain dormant, TB test positive, not contagious - latent TB - patient has immunity to TB
4
Q
If tubercle ruptures…
A
bacilli will spread to upper lobes of lungs - active disease - pulmonary TB
- can spread to brain, bones, urinary tract
- may rupture decades later
5
Q
Risk Factors for TB
A
- HIV/AIDs
- Altered immune system
- Homelessness
- Alcohol abuse
- Foreign born
- Racial/ethnic minorities
6
Q
Prevention of TB
A
- screen high risk people with PPD
- Prophylactic treatment of latent disease
- compliance with treatment
- hospitalized patient in negative airflow room with “Airborne Precautions” sign on door
- Staff wear fitted N-95 mask/particulate mask (95%)
7
Q
Induration
A
swelling, bump on skin
8
Q
Clinical Manifestations
A
- Fatigue
- Weight loss
- Decreased appetite
- Low grade fever
- Night sweats
- Cough - dry first, then productive and/or bloody
- pneumothorax
9
Q
Diagnostic Tests
A
- Positive PPD test?
- Sputum smear for acid-fast bacilli
- Sputum culture
- CXR
- HIV test
10
Q
Therapy to prevent active disease
A
- postive PPD, negative CXR
- household exposure to TB
***single drug treatment: INH for 6-9 months
11
Q
If INH contraindicated…
A
BCG vaccine, will likely always have positive PPD
12
Q
Treatment of active TB
A
- need more than one drug or bacilli will mutate to drug resistant bacteria
- 6 months or more med treatment are needed if bacilli protected in tubercle
- newly diagnosed: 4 meds x 2 months
***INH, rifgampin, pyrazinamide, ethambutol x 2 months
***INH and rifampin x 4-8 months
13
Q
Most common meds
A
Rifampin and INH (Isoniazid)
-really strong meds, can cause Hepatits
14
Q
Rifampin
A
- causes body fluids to turn red-orange
- No ASA
- May cause hepatitis
- Monitor CBC, LFTs, renal labs for toxicity
- skipped dose may lead to fever, flu-like symptoms
15
Q
INH
A
Isoniazid
- need pyridoxine (vit B6) concurrently to avoid peripheral neuropathy
- Avoid alcohol
- Observe for: anemia, brusing, jaundice, peripheral neuropathy
- may cause hepatitis
