TB Flashcards
what are the classic symptoms of TB
Persistent cough lasting ≥3 weeks
Night sweats, fever, chills
Unexplained weight loss, chest pain, fatigue
Hemoptysis (coughing up blood) and dyspnea (late stages)
Hypoxia due to lung damage
what are the symptoms in immunocompromised patients
Atypical symptoms (e.g., may lack fever or cough)
Cognitive changes (in older adults) could be the first sign
what are the risk factors?
HIV/AIDS (CD4 <200 → higher risk)
Homelessness
Close living quarters (prisons, shelters, long-term care facilities)
IV drug use
Malnutrition
Immunosuppressive therapy
what is the complication of miliary TB
Widespread dissemination via bloodstream, life-threatening
what is the complication of pleural TB
Pleural effusion, empyema
what is the complication of TB meningitis?
Neurologic symptoms (seizures, altered mental status)
what is the complication of Pott’s disease
Spinal tuberculosis, vertebral destruction
what do tests show?
Sputum culture for acid-fast bacilli (AFB) (requires 3 consecutive morning samples)
Tuberculin Skin Test (TST) or Interferon-Gamma Release Assays (IGRAs)
IGRAs (e.g., QuantiFERON-TB Gold) are more specific than TST
Chest X-ray:
Upper lobe infiltrates, cavitary lesions, lymphadenopathy
what is class 2?
latent TB
what is class 3?
active TB
what is class 4?
TB, but no longer infectious
what is class five?
TB suspect (diagnosis pending)
what is the treatment for TB?
Initial Phase (2 months):
Isoniazid (INH)
Rifampin (RIF)
Pyrazinamide (PZA)
Ethambutol (EMB)
Continuation Phase (4 months):
INH and RIF
what is the side effect of Isoniazid (INH)
Hepatotoxicity, peripheral neuropathy (take vitamin B6 to prevent neuropathy)
what is the side effect of Rifampin (RIF):
Hepatotoxicity, orange-colored body fluids (tears, urine)
what is the side effect of Pyrazinamide (PZA):
Liver toxicity, hyperuricemia, joint pain
what is the side effect of Ethambutol (EMB)
Ocular toxicity (loss of red-green color discrimination)
what is the treatment for drug resistant TB?
Treatment: Requires fluoroquinolones, injectable antibiotics, and second-line drugs for ≥18 months
Drug-resistant TB is a major global health concern, and MDR-TB and XDR-TB (extensively drug-resistant) are harder to treat and have higher mortality rates
How do you prevent spread of TB
Wear a mask, cover coughs and sneezes
Avoid crowds and ensure good ventilation
Adhere to medications
when is Pt non-infectious
typically considered non-infectious after 2 consecutive negative sputum cultures, usually after ≥2 weeks of treatment.
what should pt do?
Avoid alcohol (increases hepatotoxicity)
Avoid antacids (affects drug absorption)
Don’t miss doses (can lead to drug-resistant TB)
Complete full course of antibiotics to avoid relapse or development of drug resistance
