TB Flashcards
tuberculosis
active infection in the lungs caused by the bacteria mycobacterium, which is aerobic bacillus rod-shaped and needs a lot of O2 to grow/spread
how is TB characterized?
granulomas in the lungs (nodular accumulations of inflammatory cells)
how is TB transmitted? what infection precaution?
humans, cattle, or birds transmit tubercle bacilli (infectious particles)
airborne precaution: N95 mask, private, negative pressure room
why is TB difficult to treat?
slow growning organism
in a healthy person, what happens when exposed to TB?
the bacteria is contained by the immune system; bacilli are isolated in granulomas (tubercles) - remains dormant for life
*LATENT TB - no clinical evidence of disease
if a person with latent TB immune system is impaired, what happens?
reactivation of the bacteria + spread through body
common reactivations of latent TB
HIV, immunosuppressive medications, poor nutritional status, renal common reactivators
symptoms of active TB
develop gradually
fatigue, weight loss, lethargy, anorexia, low-grade fever, productive cough, night sweats, anxiety
later in the disease: dyspnea, chest pain and hemoptysis can occur
extrapulmonary TB
neurological deficits, meningitis symptoms, bone pain, urinary problems
screening/diagnosis of TB: high risk vs. non high risk
high risk: interferon-gamma release assay (IGRA blood draw)
non-high risk: TB skin test (“Mantoux test”)
*confirm results through sputum stain + culture and CXR to look for granulomas
pharm for TB
isoniazid (INH)
rifampin
ethambutol
pyrazinamide
streptomycin
considerations with anti-TB drugs
patient may have contracted a drug-resistance organism or drug toxicity
drug susceptibility tests completed
*CDC recommends always using more than 1 bc of the increasing presence of resistance
drug-resistant TB
more of an issue with:
HIV/AIDS community, homeless, malnourished, substance-users, cancer patients, immunosuppressed, people living in crowded/poor sanitation housing
HIGH RISK: asian + hispanic immigrants in US
referred to as “MDR-TB” (multi-drug resistant TB)
how is MDR-TB treated?
second-line drugs