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foundations pulm exam > TB > Flashcards

TB Flashcards

1
Q

what is the leading cause of the global TB crisis?

A

HIV/AIDS

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2
Q

what organism causes pulmonary TB?

A

mycobacterium tuberculosis

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3
Q

how is pulmonary TB transmitted?

A

airborne droplets by person with ACTIVE TB infection

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4
Q

are people with latent TB infectious?

A

no

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5
Q

what does the CXR look like with latent TB?

A

normal CXR

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6
Q

vast majority of latent TB go on to have reactivated TB?

A

no

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7
Q

if you test positive and exposed to someone with TB, is there potential to go on to have reactivated infection?

A

yes

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8
Q

reactivation TB causes what?

A

HIV

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9
Q

what kind of granulomas does TB have?

A

necrotizing (caseating)

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10
Q

in primary TB (initial infection), what percentage develop active vs latent infection?

A

5% develop active infection (progressive primary TB) vs 95% develop latent TB infection

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11
Q

in secondary TB, latent TB causes what?

A

reactivated TB which is now an active disease

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12
Q

half of the LTBI conversions to reactivated disease occur within the first _______ years after infection

A

2

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13
Q

do primary, secondary or both TBs cause capitary lesions?

A

both

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14
Q

what is the strongest risk factor for progression of active TB?

A

HIV

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15
Q

if you breathe TB into your lungs, list the 4 things that might happen

A
  1. you don’t become infected with TB
  2. you develop latent TB
  3. you develop active TB
  4. you develop active TB years after initial infection
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16
Q

what medication is taken to prevent reactivated TB?

A

INH (isoniazide) caution with hepatotoxicity in > 35 y/o

17
Q

a pt with latent TB will have what kind of symptoms?

A

no symptoms but will have a positive skin test, but not infectious

18
Q

what are symptoms for a patient with active TB infection?

A 
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
19
Q

what is the classic finding you find in a pt with pulmonary TB?

A

post-tussive rales

20
Q

what do you see on CXR in pt with primary active TB?

A

hilar adenopathy

21
Q

what do you see on the CXR in pt with reactivation disease?

A

apical/upper lobe infiltrates and cavitations

22
Q

what is the gold standard in diagnostic testing for pulmonary TB?

A

sputum culture

need 3 consecutive morning sputum specimens

23
Q

how long after a TB infection would a reaction occur in skin testing?

A

4-10 weeks

24
Q

in the mantoux test, PPD, what are you meausring

A

induration, not erythema

25
Q

if BCG (bacillus calmette-guerin) positive, what do you do next?

A

do a blood test (IGRA)

26
Q

the more reactive you are to TB, the _______ amount of induration will be accepted?

A

smaller

27
Q

what are specific and sensitive tests for diagnosing pulmonary TB?

A

T-SPOT and TB Gold

28
Q

when making an active TB diagnosing, you must report within what time period?

A

24 hours

29
Q

CDC recommends ______ for all pts with drug-resistant TB

A

DOT (Directly Observed Therapy) in initiating treatment

30
Q

What are the 4 drugs you could use in treating pulmonary TB?

A

Rifampin
Isoniazid
Pyrazinamide
Ethambutol

31
Q

what is the #1 medication used in treating latent TB infection?

A

isoniazid x9 months with vitamin B6 added too

32
Q

what provider monitors TB?

A

pulmonology or ID

33
Q

what are rifampin SE?

A

excreted as red-orange compound in tears, sweat, urine, stool

34
Q

what are isoniazid SE?

A

hepatitis

peripheral neuropathy

35
Q

what are pyrazinamide SE?

A

hepatic toxicity

hyperuricemia

36
Q

what are ethambutol SE?

A

optic neuritis

foundations pulm exam (10 decks)

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