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Tb Flashcards

1
Q

What is the recommended number of sputum specimens for TB bacteriologic examination?

A

At least 3 sputum specimens

Collected in 8-24 hour intervals with at least one early morning specimen.

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2
Q

What is an induced sputum sample?

A

Patient inhales saline mist, causing deep coughing.

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3
Q

What is gastric lavage in the context of TB diagnosis?

A

A tube is inserted through the nose into the stomach to obtain gastric secretions that may contain sputum.

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4
Q

What is the purpose of bronchoscopy in TB diagnosis?

A

To obtain pulmonary secretions or lung tissue.

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5
Q

What type of laboratory is needed for TB bacteriologic examination?

A

A laboratory that specifically deals with M. tuberculosis and other mycobacteria.

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6
Q

What microscopy technique is used in TB bacteriologic examination?

A

Ziehl-Nielsen stain.

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7
Q

What is the significance of a negative culture in TB diagnosis?

A

Negative culture does not rule out TB disease.

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8
Q

What is the recommendation for BCG immunization in Zambia?

A

BCG immunization for all neonates is recommended, except for those with symptomatic HIV disease.

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9
Q

What percentage of children may develop complications following BCG vaccination?

A

1-2%.

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10
Q

What are common complications following BCG vaccination?

A

Local abscesses.

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11
Q

What clinical methods are used for diagnosing TB in children?

A

Clinical history, physical exam, and TB score.

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12
Q

What does a chest x-ray help rule out in TB diagnosis?

A

The possibility of pulmonary TB disease in persons with a positive TST result.

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13
Q

Can chest x-rays confirm TB disease?

A

No, only bacteriologic culture can prove TB disease.

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14
Q

What is a positive reaction in the Mantoux Tuberculin Skin Test for people living with HIV?

A

Induration of > 5 mm.

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15
Q

What is the induration measurement considered positive for all children in the Mantoux test?

A

Induration of > 10 mm.

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16
Q

What is the induration measurement for people with no known risk factors in the Mantoux test?

A

Induration of > 15 mm.

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17
Q

Who should administer or observe TB treatment in children?

A

A trained community member or a health-care worker.

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18
Q

What are AFB in the context of TB diagnosis?

A

Mycobacteria that remain stained after being washed in acid solution.

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19
Q

What are potential findings on a chest x-ray for a person with TB disease?

A

Persistent infiltrate, primary complex, enlarged hilar lymph nodes, diffuse small nodular opacities.

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20
Q

What does the TB score assess?

A

Length of illness, nutrition, family history of TB, unexplained symptoms, and diagnostic imaging.

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21
Q

What are the main objectives of anti-TB treatment?

A
  • Cure the patient
  • Prevent death
  • Prevent relapse
  • Prevent drug resistance
  • Decrease transmission
22
Q

What can cause hepatotoxicity during TB treatment?

A

Isoniazid, rifampicin, or pyrazinamide.

23
Q

What is drug-resistant TB?

A

TB caused by M. tuberculosis organisms resistant to at least one TB treatment drug.

24
Q

What defines multidrug-resistant TB (MDR TB)?

A

Resistant to at least isoniazid and rifampin.

25
What is the treatment regimen for drug-resistant TB in complicated cases?
Prednisone 2 mg/kg daily for 4 weeks.
26
What is the monitoring process during TB treatment?
Direct observation of medication intake, daily weight gain, and twice daily temperature checks.
27
What factors can cause false-positive reactions in the Mantoux test?
* Infection with non-tuberculous mycobacteria * BCG vaccination
28
What can cause false-negative reactions in the Mantoux test?
* Immunosuppression * Recent TB infection * Age under 6 months * Recent live-virus vaccination
29
What is latent TB infection (LTBI)?
Occurs when tubercle bacilli are in the body but the immune system keeps them under control.
30
What is the probability of TB transmission dependent on?
* Infectiousness of the person * Environment of exposure * Length of exposure * Virulence of bacilli
31
What was TB historically known as?
* Consumption * Wasting disease * White plague
32
When was the first TB drug detected?
1943.
33
What caused the resurgence of TB in the mid-1980s?
* Inadequate funding for TB control programs * HIV epidemic * Increase in multidrug-resistant TB
34
What is another name for tuberculosis?
Consumption Wasting disease White plague
35
Who discovered the bacterium that causes TB and in what year?
Robert Koch in 1882
36
What was the first TB drug detected and in what year?
Streptomycin in 1943
37
What factors contributed to the resurgence of TB in the mid-1980s?
* Inadequate funding for TB control programs * HIV epidemic * Increase and spread of multidrug-resistant TB
38
Which type of Mycobacteria causes most TB cases?
M. tuberculosis
39
List other mycobacteria that can cause TB.
* M. bovis * M. africanum * M. microti * M. canetti
40
What are some mycobacteria that do not cause TB?
M. avium complex
41
How is TB primarily spread?
Person to person through the air via droplet nuclei
42
What actions can expel M. tuberculosis into the air?
* Coughs * Sneezes * Speaks * Sings
43
What is the risk of developing TB disease for individuals co-infected with HIV?
About 7% to 10% PER YEAR
44
What is the difference between Latent TB Infection (LTBI) and TB Disease?
* LTBI: Inactive, contained tubercle bacilli * TB Disease: Active, multiplying tubercle bacilli
45
What are the TST or blood test results for LTBI?
Usually positive
46
What are common symptoms of TB disease?
* Cough * Fever * Weight loss
47
What is the Mantoux Tuberculin Skin Test (TST)?
A test administered by injection using proteins derived from inactive tubercle bacilli
48
What are common sites for TB bacilli to reach in the body?
Any part of the body
49
What are physical signs requiring investigation to exclude extrapulmonary TB?
* Meningitis not responding to antibiotic treatment * Pleural effusion * Pericardial effusion * Distended abdomen with ascites * Non-painful enlarged lymph nodes without fistula formation * Non-painful enlarged joint or deformity at the spine * Signs of tuberculin hypersensitivity (e.g. erythema nodosum)
50
What symptoms should clinicians ask about during medical history for TB?
* Weight loss * Prolonged fever * Cough lasting 3 or more weeks * Chills * Night sweats * Appetite loss * Fatigue * Malaise
51
Coughing up sputum or blood is rare in which age group?
Older kids

Peads Tb (2 decks)

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