TB Flashcards
Who are the most at risk of TB in Canada?
First Nations
What organism causes TB?
mycobacterium tuberculosis
How does TB spread?
air droplets
What are risk factors for TB?
endemic areas, indigenous, homeless, prison, PWID, HIV, prior infection
What factor puts you at highest risk?
HIV
What is primary infection?
inhale droplet nuclei
At what point in primary infection does INF-Y get produced?
3 weeks
WHat is DTH?
delayed hypersensitivity- kills immature macrophages that help bacteria replicate
What does a positive tubercukin skin test mean?
protection
What extrapulmonary complications are likely?
lymph or pleural disease, Increases HIV, miliary TB, bones
Sx of TB?
weight loss, hemoptysis- cough up blood
How do you do a TB skin test?
measure bump, lots of false negatives
What drug is best for extracellular TB?
INH, rifampin, streptomycin
What is best drug for granulomas TB?
pyrazinamide, rifampin
What is treatment of latent TB?
rifampin for 4 months and rifapentine and INH weekly for 3 months
What is treatment of active TB?
isonazid, rifampin, pyrazinamide and ethambutol for 6 months the INH and RMP for 4 months total
If latent treatment, what happens if i cant tolerate rifamycin?
INH for 9 months
If active treatment, what happens if i cant use pyrazinamide?
9 months of RMP and INH
Who cannot get thrice weekly continuation. phase treatment?
HIV positive
How does Isoniazid work? BAd things about it?
stop wall synthesis
BAd- neurotox, hepatotox
Rifampin MOA and issues?
MOA- stop RNA synthesis
Bad- hepatotx, secretions orange
Why use rifabutin? What is bad about it?
less DI
hypersensitivity
WHat is issue with pyrazinamide?
gi, uric acid increase, hepatotox
How does ethambutol work?
bacteriostatic and lowers resistance
