TB

Question 1

Basically, what is primary infection of TB?

biopsy will show?

Answer 1

a pneumonia not getting better and evntually the body walls it off causing cavitating lesions
caseating granulomas

Question 2

what is secondary infection?

Answer 2

reactivation of the TB. ghon complex apical lesions. body is going after the TB and destroys the lung.

Question 3

3 additional symptoms when it is secondary infection?

Answer 3

coughing up blood
night sweats
weight loss

Question 4

when you do the skin screening for TB, what do you do next if they have a positive ppd?

Answer 4

chest x ray

Question 5

if the chest x ray is negative what do they have and how do you treat it?

Answer 5

latent TB

ISO and b6 for 9 months.

Question 6

if chest x ray negative what do you do next?

Answer 6

afb smear to see if they are infectious

Question 7

What do we do with a negative and positive afb smear?

Answer 7

negative, it is latent and treat iso and b6 for 9 months. 
psoitive, active tb, ripe
Rifampin, changes everything red/orange
Iso, peripheral neuropathy
Pyram, hyper uric acid, gout
Ethambutol, red green color blindness

Question 8

what constitutes a positive PPD?

Answer 8

really immunocomprimsed and close contacts, greater than 5
risk factor people greater than 10
everyone else greater than 15

Question 9

what is an equivalent test to PPD?

Answer 9

interferon gamma assay

Question 10

How do you screen someone who has the BCG vaccine?

Answer 10

ignore it and roll with PPD. if we can choose to get interferon gamma instead of PPD it is good because it eliminates false positives.

Question 11

someone comes in with what you think is active TB, what do you do?

Answer 11

chest x ray and afb smears. if negative probably something else.

if positive chest x ray and smear, active tb and ripe.

if positive x ray and negative smear, latent tb, iso with b6 for 9 months