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CD > TB > Flashcards

TB Flashcards

1
Q

what are the three causative agent of pulmonary tb?

A

mycobacterium tuberculae

mycobacterium africanum

mycobacterium bovis

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2
Q

what do the three causative agent do in the lungs?

A

they attack the lung tissue

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3
Q

what lung tissue do the causative agents attack specifically?

A

lung parenchyma

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4
Q

what organs do the causative agent attack other than the lungs?

A

heart, liver, throat

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5
Q

mode of transmission of tb

A

airborne
droplet
milk as a vehicle

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6
Q

how milk posturized?

A

pasteurization of milk, designed to destroy the pathogen COXIELLA BURNETTI, is accomplished by a time/temp. integrated process.

63 degrees Celsius for 30 minutes
71.7 or 72 for 15 minutes

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7
Q

incubation period for TB

A

2-10 weeks

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8
Q

enumerate the cardinal signs of TB

A

cough
night sweat
weight loss
anorexia
loss of appetite
hemoptysis
low grade fever

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9
Q

what. are the two direct sputum smear microscopy of tb?

A

conventional strategy (spot)

spot-spot

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10
Q

in conventional spot, when do the patient return?

A

early morning the next day

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11
Q

how many specimen in spot-spot?

A

3

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12
Q

what are the 3 specimen in spot-spot?

A

one spot
2nd spot
3rd spot

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13
Q

one spot

A

right there and then

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14
Q

2nd spot

A

after 1 hour

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15
Q

3rd spot

A

the next day early in the morning

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16
Q

nursing consideration for direct spot smear microscopy

A

no mouthwash, plain water only

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17
Q

what are the 3 diagnostic test for tb

A

direct spit smear microscopy
sputum analysis
tuberculin skin test or mantoux test

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18
Q

in sputum analysis, what indicates 2 positive specimen?

A

positive tb

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19
Q

in sputum analysis, what indicates 1 positve and 1 negative specimen?

A

needs chest xray

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20
Q

what procedure determines the extent of the lesion?

A

chest xray

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21
Q

other term for tuberculin skin test

A

purified protein derivative or mantoux test

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22
Q

what is tuberculin test?

A

to test susceptibility exposure and immunity of tuberculosis

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23
Q

how to determine if it is positive of tuberculin test?

A

wheal formation or induration

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24
Q

size of wheal formation?

A

10mm

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25
Q

route of tuberculin skin test?

A

intradermal

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26
Q

how many ml do they inject in tuberculin skin test? what site?

A

0.1 ppd injected to left forearm

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27
Q

how many days do they wait for the result of tuberculin test?

A

2-3 days or 48-72 hours

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28
Q

classification based on history of previous TB treatment

A

new
relapse
treatment after failure
treatment after lost of follow up (talf)
previously treatment outcome unknown (ptou)
other

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29
Q

discuss NEW

A
  • newly diagnosed patient
  • positive sputum smear
  • someboday who have taken anti-TB dugs for less than a month
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30
Q

discuss RELAPSE

A

might have been cured but diagnosed to have
tB again

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31
Q

discuss treatment after failure

A

finished treatment regimen but
Still have TB ; never cured

32
Q

discuss TALF

A

started tx however never follow-up for
2 months

33
Q

discuss PTOU

A

claimed that pt has undergone TB tx however there’s ‘ no treatment record or document no evidence

34
Q

discuss OTHER

A

pt who does not fit to any category

35
Q

what are the recommended category of treatment regimen?

A

c1,c2,c3,c4

36
Q

C1

A

+ sputum mear
-newly diagnosed pt
-extensive Parenchymal lesion
- seriously ill

37
Q

c2

A
  • relapse
    -treatment after failure
    -TALF, PTOU
  • other
38
Q

C3

A
  • newly diagnosed
  • (+)sputum smear
  • slightly / minimal lesion
39
Q

C4

A

-chronic PTB
-still w/ TB after supervised treatment
-chronic PTB
- Helpless/ hopeless

40
Q

drugs for C1

A

2 months HRZE
4 months HR

41
Q

drugs for C2

A

2 months HRZES
5 months HRE

42
Q

drugs for C3

A

2 months HRZ
4 months HR

43
Q

drugs for C4

A

none

44
Q

intensive phase

A

2 months

45
Q

maintenance phase

A

4 months except C2

46
Q

maintenance phase of C2

A

5 months

47
Q

First line drugs of TB

A

Rifampicin
(H) Isoniazid
(Z) pyrazinamide
Ethambutol
Streptomycin

48
Q

SE of rifampicin

A

red orange urine, tears, sweats

49
Q

SE of isoniazid

A

peripheral neuritis/neuropathy (tingling and numbness of the extremities)

50
Q

SE of pyrazinamide

A

hyperurecemia
nephrotoxicity
hepatotoxicity

51
Q

management for hyperurecemia

A

no purine rich food such as organ meats

52
Q

what labs do nurses monitor for pt taking pyrazinamide with a side effect of nephrotoxicity?

A

BUN and Creatinine

53
Q

normal BUN and creatinine?

A

BUN - 10-20mg/dl
Creatinine - 0.4-1.2

54
Q

what labs do nurses monitor for pt taking pyrazinamide with a side effect of hepatotoxicity?

A

AST and ALT

55
Q

SE of ethambutol

A

optic neuritis
damage eyes
loss of vision (transient or temporary)
difficulty discriminating yellowish-green

56
Q

what specific part of the eyes do ethambutol affects?

A

optic disc

57
Q

nursing consideration for loss of vision

A

snellen chart

58
Q

nursing consideration for difficulty discriminating yellow-green color

A

Ishihara diagram

59
Q

what cranial nerve do streptomycin affects?

A

8th cranial nerve ( acoustic nerve)

60
Q

SE of streptomycin

A

tinitus
vertigo
loss of balance
ototoxicity

61
Q

second line of drugs of tb

A

amikacin
kanamycin
capreomycin

62
Q

classification of second line drugs

A

amino glycosides

63
Q

route of second line drugs

A

IV or IM

64
Q

SE of second line drugs

A

ototoxicity
hepatotoxicity
nephrotoxicity

65
Q

Other second line drugs

A

Ciprofloxacin
moxifloxacin
levofloxacin

66
Q

classification of other second line drugs

A

fluoroquinolones

67
Q

route of other second line drugs

A

per orem

68
Q

SE of other second line drugs

A

headache
N/V

69
Q

No LIVE VAXX for?

A

immunocompromised patients

70
Q

Prevention/ vaccine for TB

Content:
Given when:
Dosage:
# if doses:
route:
old sched:
new sched:
SE:

A

Content: LIVE ATTENUATED BACTERIA
Given when: AT BIRTH
Dosage: 0.05 ML
# if doses: 1
route: INTRADERMAL
old sched: AT BIRTH
new sched: AT BIRTH
SE: PERMANENT SCAR, LOCAL SORENESS, FEVER

71
Q

nursing consideration for local soreness

A

apply warm compress
do not massage the scar

72
Q

nursing considerations for fever

A

give antipyretics
continue breastfeeding

73
Q

Absolute considerations for LIVE ATTENUATED BACTERIA

A

cough, hiv, aids, immunocompromised

74
Q

contraindications for any vaxx

A

chemotherapy
glucocorticoids therapy ( sone)
for fever more than 38.5

75
Q

vaccine reconstitution

A

BCG

76
Q

BCG:

Diluent:
Syringe:
Discharge:

A

Diluent: sterile water: 2-3 ml
Syringe: 5cc
Discharge: after 4 hrs

CD (11 decks)

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