TB Flashcards
what is the leading cause of the global TB crisis?
HIV/AIDS
what organism causes pulmonary TB?
mycobacterium tuberculosis
how is pulmonary TB transmitted?
airborne droplets by person with ACTIVE TB infection
are people with latent TB infectious?
no
what does the CXR look like with latent TB?
normal CXR
vast majority of latent TB go on to have reactivated TB?
no
if you test positive and exposed to someone with TB, is there potential to go on to have reactivated infection?
yes
reactivation TB causes what?
HIV
what kind of granulomas does TB have?
necrotizing (caseating)
in primary TB (initial infection), what percentage develop active vs latent infection?
5% develop active infection (progressive primary TB) vs 95% develop latent TB infection
in secondary TB, latent TB causes what?
reactivated TB which is now an active disease
half of the LTBI conversions to reactivated disease occur within the first _______ years after infection
2
do primary, secondary or both TBs cause capitary lesions?
both
what is the strongest risk factor for progression of active TB?
HIV
if you breathe TB into your lungs, list the 4 things that might happen
- you don’t become infected with TB
- you develop latent TB
- you develop active TB
- you develop active TB years after initial infection
what medication is taken to prevent reactivated TB?
INH (isoniazide) caution with hepatotoxicity in > 35 y/o
a pt with latent TB will have what kind of symptoms?
no symptoms but will have a positive skin test, but not infectious
what are symptoms for a patient with active TB infection?
bad cough that lasts 3 weeks or more may see productive cough or may see hemoptysis chest pain fever, chills, night sweats weakness, fatigue anorexia, weight loss
what is the classic finding you find in a pt with pulmonary TB?
post-tussive rales
what do you see on CXR in pt with primary active TB?
hilar adenopathy
what do you see on the CXR in pt with reactivation disease?
apical/upper lobe infiltrates and cavitations
what is the gold standard in diagnostic testing for pulmonary TB?
sputum culture
need 3 consecutive morning sputum specimens
how long after a TB infection would a reaction occur in skin testing?
4-10 weeks
in the mantoux test, PPD, what are you meausring
induration, not erythema
if BCG (bacillus calmette-guerin) positive, what do you do next?
do a blood test (IGRA)
the more reactive you are to TB, the _______ amount of induration will be accepted?
smaller
what are specific and sensitive tests for diagnosing pulmonary TB?
T-SPOT and TB Gold
when making an active TB diagnosing, you must report within what time period?
24 hours
CDC recommends ______ for all pts with drug-resistant TB
DOT (Directly Observed Therapy) in initiating treatment
What are the 4 drugs you could use in treating pulmonary TB?
Rifampin
Isoniazid
Pyrazinamide
Ethambutol
what is the #1 medication used in treating latent TB infection?
isoniazid x9 months with vitamin B6 added too
what provider monitors TB?
pulmonology or ID
what are rifampin SE?
excreted as red-orange compound in tears, sweat, urine, stool
what are isoniazid SE?
hepatitis
peripheral neuropathy
what are pyrazinamide SE?
hepatic toxicity
hyperuricemia
what are ethambutol SE?
optic neuritis
