PTB Flashcards
Highly infectious chronic dse. Caused by tubercle bacilli
Pulmonary TB
CAUSATIVE AGENTS
- Mycobacterium tuberculae
- M. Africanum
- M. Bovis
Classification
Bacterial
TB among children
Primary complex (not contagious)
2 types of TB
- Pulmonary TB- micro-bacterium within lungs
- Extrapulmonary TB- adjacent organs
Mode of transmission
D, A, D, I
DROPLET
AIRBORNE
DIRECT INVASION (rare)
INGESTION OF UNPASTEURIZED MILK OR DAIRY PRODUCTS
Extreme temp to destroy microorganisms in unpasteurized milk
63 deg celsius (30mins)/71.6-71.7 deg F (5-15secs)
Incubation period
2-8 wks (12 wks max)
Period of communicability
- while bacillus is in the sputum
- good compliance to regimen (not contagious 2-4 wks. After)
Terminologies
C, H, H
- Close contact
- High risk group
- High risk clinical group
Close contact
Enclosed space for 3 mos.
High risk group
Closed environment (prison cell, skin-to-skin contact)
High risk clinical group
AIDS/HIV/DM/RF (immunocompromised pt.)
6 Cardinal sign of PTB
C, NS, WL, A, H, LGF (CNS, WLAH, LGF)
Cough productive
Night sweats
Weight loss
Anorexia
Hemoptysis
Low grade fever in the afternoon
Dx test
- DSSM (Direct sputum smear microscopy)
- X-rays
- TST (Tuberculin Skin Test- primary complex)
DSSM
Conventional strategy (SPOT)
Instruct the patient to return the next day, early in the morning
DSSM
SPOT-SPOT
3 SPECIMENS
1st- right away/after chief complaint
2nd- after 1 hr
3rd- the next day, early in the morning
Sputum analysis
If 2 sputum are (+) = PTB
If 1 (-) and 1 (+) = Chest x-ray
Classification based on history of previously TB treatment
N, R, T, T, O, P (Nursing Reaching To TOP)
New pt.
Relapse pt.
Treatment after failure
Treatment after loss to follow up pt.
Other previously treated pt.
Pt. With unknown previous TB treatment history
New pt
Not yet diagnosed/ with TB before and taking anti-tubercular drug for 2 mos.
Relapse pt.
After receiving treatment for her TB, pt. Was diagnosed again with the illness
Treatment after failure pt.
The TB treatment was unsuccessful
Treatment after loss to follow-up pt.
Return after default/loss of contract or follow up for 2 mos.
Other previously treated pt.
No known treatment/undocumented TB treatment
Pt. With unknown previous TB treatment history
Does not fit in any category under classification of previous TB treatment
DOTS
Directly Observed Treatment Short Course
- appointed person to monitor the daily intake (assigned health worker)
Intensive phase
2 mons.
Maintenance phase
4 mos.
Recommended category of treatment regimen
4C’s?
C1, 2, 3, 4
C1
- new PTB, (+) smear, extensive parenchymal lesions (lungs), seriously ill, x-ray
IP: 2 mos. HRZE (RIPE)
MP: 4 mos. HR (RI)
C2
Relapse, tx failure, return after default, and others
IP: 2 mos. HRZES (RIPES)
MP: 5 mos. HRE (RIE)
C3
New PTB, with minimal lesions, not seriously ill
IP: 2 mos. HRZ (RIP)
MP: 4 mos. HR (RI)
C4
Chronic PTB, (+) TB, (+) SPUTUM SMEAR AFTER SUPERVISED TX.
No meds
Scone line drugs: Injectables
Aminoglycosides
Kanamycin
Amikacin
Capreomycin
Second line drugs: Oral
Fluoroquinolone
Levofloxacin
Ciprofloxacin
Moxifloxacin
JAUNDICE
RIPE
Visual impairment
Ethambutol
Tinnitus and hearing impairment
Streptomycin
Oliguria and albuminiria
Strep and rifampicin
Psychosis and convulsion
Isoniazid
thrombocytopenia & anemia
Rifampicin
DR- TB
DRUG RESISTANCE- ISONIAZID
MDR- TB
MULTIPLE DRUG RESISTANCE- ISO & RIFAM
XDR-TB
EXTENSIVELY DRUG RESISTANCE- ISO, RIFAM, FLUORO
XXDR-TB
EXTREMELY DRUG RESISTACE- ISO, RIFAM, & FLUORO
TDR- TB
TOTAL DRUG RESISTANCE- ISO, RIFAM, FLUORO
RIFAM (SE)
RED ORAGE URINE, SWEAT, TEARS, SEMEN
ISO (SE)
PERIPHERAL NEURITIS (PRICKILING OR TINGLING SENSATION)
VIT B6 FOR SE
PYRAZINAMIDE (SE)
HYPERURICEMIA (INCREASED URIC ACID OR GOUT)
NEPHROTOXICITY/HEPATOTOXICITY (ALT & AST)
ETHAMBUTOL (SE)
OPTIC NEURITIS/ BLURRING OF VISION
STREP (SE)
8TH CRANIAL NERVE
VERTIGO & TINNITUS
MANTOUX TEST (PURIFIED PROTEIN DERIVATIVE)
ROUTE OF ADMINISTRATION: ID
WHEAL FORMATION
(+) 10mm - exposure to normal people
(+) 5mm- exposure to immunocompromised people (HIV/AIDS)
