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Clin Med II-Pulmonary > TB & Fungal Pneumonias > Flashcards

TB & Fungal Pneumonias Flashcards

1
Q

TB spread by

A

airborne by active TB during PROLONGED exposure

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2
Q

latent TB (LTBI)

A

bacterial walled off, no symptoms, no active infection, not infectious, may reactivated in future

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3
Q

primarily necrotizing (caseating) granulomas

A

TB

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4
Q

risk for developing reactivation TB is greater during

A

first 2 years after infection

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5
Q

secondary TB

A

reactivation of TB form LTBI

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6
Q

TB risk factors

A

immune compromise (HIV), crowded living, exposure (healthcare work), nationality (africa, asia and latin america)

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7
Q

active TB symptoms

A

fever, chill, night sweats, cough

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8
Q

pulmonary aspergillosis is a complication of

A

TB

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9
Q

lab findings of TB

A

hyponatremia (SIADH) and elevated CRP

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10
Q

interferon gamma release assays a/w

A

TB testing

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11
Q

TB CXR ?

A

shows active or inactive

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12
Q

CXR findings of active TB

A

CLASSIC: focal infiltration in upper lobes

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13
Q

Ghon/Ranke complex

A

TB: calcified primary focus and hilar lymph node, residual evidence of healed primary TB

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14
Q

gold standard for Dx of TB

A

sputum culture

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15
Q

sputum culture

A

3 consecutive morning

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16
Q

TB histologic hallmark of biopsy

A

necrotizing (ceseating) granulomas

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17
Q

TB skin testing

A

Mantoux test PPD

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18
Q

Mantoux test PPD measures

A

induration not erythema read in 48-72 hrs

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19
Q

if skin testing positive for TB then ?

A

CXR to r/o active dz

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20
Q

if 2nd tb skin test positive

A

indicates TB infection in distant past-boosted response

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21
Q

reaction size on tb skin test

A

HIV >5 mm, immigrants/healthcare related >10, nl people >15

22
Q

interferon gamma release assays benefits

A

not affected by BCG

23
Q

tx of active TB

A

RIPE x 2 months then RIF and INH x 4 months [DOT-directly observed]

24
Q

tx of latent TB

A

INH and B6 x 9 months

25
Q

what to monitor when treating TB

A

LFT

26
Q

complication of TB

A

drug resistant, miliary TB, uncontrolled hematogenous TB, multiorgan

27
Q

RIF

A

red orange tears, sweats, urine, stool

28
Q

INH

A

hepatitis, peripheral neuropathy (given w/ B6)

29
Q

PZA

A

hepatic toxicity, hyperuricemia (gout)

30
Q

EMB

A

optic neuritis

31
Q

histoplasmosis

A

caused by histoplasma capsulatum-isolated from soil contaminated w/bird or bat droppings

32
Q

asymptomatic primary histoplasmosis

A

may see residual granuloma (scar) on CXR

33
Q

acute symptomatic pulmonary histoplasmosis

A

due to prolonged exposure, fever, fatigue, few resp. symp. lasts 1 week-6 month

34
Q

progressive disseminated histoplasmosis

A

rare, fever , fatigue, cough, dyspnea, wt loss, multiple organ involvement, fatal w/in 6 weeks

35
Q

chronic pulmonary histoplasmosis

A

in COPD pts, apical cavities in lung

36
Q

lab for histoplasmosis

A

antigen detection in bronchoalveolar lavage fluid, urine, blood

37
Q

histoplasmosis cxr

A

hilar adenopathy

38
Q

tx for sever histoplasmosis

A

amphotericin B IV

39
Q

tx for chronic histoplasmosis

A

amphotericin B or itraconazole

40
Q

tx for histoplasmosis in AIDs pts

A

amphotericin B + itraconazole

41
Q

coccidioidomycosis (valley fever)

A

FEVER, cough, chest pain, ha, fatigue, arthralgias, rash (ERYTHEMA MULTIFORME), ERYTHEMA NODOSUM

42
Q

erythema nodosum in coccidioidomycosis (valley fever) vs sarcoidosis

A

valley fever has FEVER

43
Q

disseminated coccidioidomycosis

A

lung abscess, lymphadenitis, meningitis, BONE LESIONS at boney prominences

44
Q

cxr findings of coccidioidomycosis

A

hilar LAD, patchy nodular infiltrates, miliary infiltrates, THIN WALLED CAVITIES

45
Q

eosinophilia

A

coccidioidomycosis w/ slight leukocytosis

46
Q

tx of sever coccidioidomycosis

A

fluconazole, amp B IV

47
Q

coccidioidomycosis in pregnancy

A

if disseminated dz, mortality risk in both mother and fetus is high

48
Q

common SE of ..azoles

A

hepatotoxicity –>monitor liver function

49
Q

coccidioidomycosis 3 Es

A
  1. erythema nodosum 2. erythema multiforme 3. eosinophilia
50
Q

most common opportunistic infection a/w AIDS

A

pneumocytostis jiroveci pneumonia

Clin Med II-Pulmonary (7 decks)

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