TB new

Question 1

What is tuberculosis?

Answer 1

Infection caused by BACTERIAL organisms such as Mycobacterium.tuberculosis, africanum, bovis or microti

Question 2

What does TB effect?

Answer 2

Lungs (pulmonary) but can also affect outside the lungs e.g. CNS or heart, this is extrapulmonary tuberculosis

Question 3

Symptoms

Answer 3

• coughing for more than 3 weeks with phlegm (normally bloody)
• night sweats, fever
• weakness and weight loss

Question 4

2 types

Answer 4

Active - symptomatic
Latent - you have mycobacterium tb but it is contained, no symptoms

Question 5

When can latent TB become active

Answer 5

• immunocompromised
• diabetic
• receiving treatment with TNF-a

Question 6

Who should be tested for latent Tb?

Answer 6

• 65+ in close contact
• Immunocompromised
• New NHS employees who came from high incidence of Tb countries

Question 7

Latent TB treatment

Answer 7

1. Isoniazid for 6 months
2. Rifampicin + Isoniazid for 3 months

Vitamin B6 pyridoxine in conjunction – for peripheral nephropathy

Question 8

Phases of treatment

Answer 8

Initial phase
- 2 months
- 4 drugs

Continuation phase (4 months)
- 4 months
- 2 drugs

Question 9

Initial phase

Answer 9

• Rifampicin
• Isoniazid
• Pyrazinamide
• Ethambutol
  2 months
  RIPE

Question 10

Continuation phase

Answer 10

• Rifampicin
• Isoniazid
  4 months

Question 11

How long in total is the treatment for active Tb?

Answer 11

6m

Question 12

Describe the unsupervised and supervised treatment regimens in treatment of TB?

Answer 12

• Unsupervised regimens are for those who are likely to take antituberculosis therapy without the need for
  supervision
• Patients who are unable or unlikely to comply with daily administration of therapy should be treated with regimen described under supervised treatment

Question 13

Who should be offered supervised treatment (direct observed therapy) for TB?

Answer 13

• non-adherence
• previous treatment for TB
• homelessness, drug or alcohol misuse
• in prison or young offender, or have been in past 5 yrs
• major psychiatric, cognitive or memory disorder

Question 15

Can treatment for TB be taken in pregnancy or breastfeeding?

Answer 15

• Standard six month treatment regimen may be used in pregnancy and breastfeeding
• but NOT streptomycin

Question 16

Give an example of indicators for
compliance of tb treatment?

Answer 16

• Monthly count of tablets
• Urine examination (e.g.
  Rifampicin gives an orange-red coloration)