TB, Histoplasmosis, Cocci Flashcards
How is TB transmitted?
Airborne droplet nuclei expelled with coughing, sneezing, etc
When can latent TB become activated to disease state?
If patient becomes immunocompromised and granulomas break down
When do symptoms of TB typically present?
Within weeks of exposure or years later when immune system is compromised
What population is at the highest risk of TB?
Untreated HIV
When are patients infected with TB become contagious?
During active disease
When is a chest x-ray indicated when evaluating for TB?
Recommended with positive infection testing or symptoms present
Cannot confirm diagnosis but may be able to rule out
What are four TB risk factors?
- Immunocompromised
- Immigrants from areas with high TB prevalence
- Injection drug users
- Close living quarters
What symptoms are associated with active TB?
- Fever
- Cough for 3+ weeks (+/- productive)
- Hemoptysis (+/-)
- Chest pain (pleuritic or retrosternal)
- Weight loss, anorexia
- Chills, night sweats
What symptoms are associated with active TB?
- May be normal
- Posttussive crackles (classic finding)
- Dullness or decreased fremitus
- Lymphadenopathy
- Clubbing (severe)
What is measured in TB skin testing?
The size of induration
When would you obtain a QuantiFeron-TB Gold blood draw?
May be used in place of skin test if concerns of patient not returning for reading or patient received BCG vaccination
What may be seen on chest x-ray in an individual with primary active TB?
- Hilar lymphadenopathy or normal
- May progress with pleural effusions and/or infiltrates
- Cavitation seen with progressive pulmonary TB
- Miliary pattern
Where are abnormalities typically seen in the lungs with TB?
Apical/posterior upper lobes because the bacteria is an obligate aerobe and requires oxygen
What is the gold standard to confirm diagnosis of TB?
Sputum culture
What should you do if the patient has both a positive AFB and NAA?
TB disease is presumed and treatment begins
