TB

Question 1

tb

Answer 1

any infection caused by mycobacterium tb (MTB) most common but others
aerobic bacillus rod shaped: need lots of o2 0> lungs! (slow growing, hard to treat, we usually slow growth)
granulomas in lungs -> nodular accumulations of inflam cells (macrophages and lymph - hard outside casing) cheesy inside (casein)
transmit via humans, cattle, birds (airborne), get to lungs via blood and lymph

Question 2

infectious

Answer 2

usually contained by immune system
latent = no evidence of disease
sometimes bacilli are isolated in granulomas (tubercles) and dormant for life, if immune system becomes impaired -> bacteria reactivate and spread (HIV, immunosuppressed, steroids, poor nut, renal fail)

Question 3

active

Answer 3

s develop gradually -> usually not noticed intil very advanced
fatigue, weight loss, lethargy, anorexia, low fever (afternoons), cough-P (over months), night sweats, anx
later s: dyspnea, chest pain, hemoptysis
extrapulmonary tb: usually confined to lungs, neuro deficits, meningitis s, bone pain, urinary problems

Question 4

screen and diagnose

Answer 4

high risk pop: interferon gamma release assay (blood draw), if + -> sputum C+S, and granulomas on CXR
non high risk -> skin test

Question 5

drug resistant

Answer 5

bigger issue with HIV/AIDS
+ homeless, undernourished/malN, substance users, cancer pt, immunosuppressed, crowded, poor sanitaiton
asian and hispanic immigrants in us -> usually bring it
treat with second line (not as effective)