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Cadiopulmonary Medicine > Test 3 Ch. 19 Tuberculosis > Flashcards

Test 3 Ch. 19 Tuberculosis Flashcards

1
Q

A contagious chronic bacterial infection that primarily affects the lungs, although it may involve almost any part of the body

A

Tuberculosis (TB)

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2
Q

TB is classified as (3)

A
  • Primary TB
  • Reactivation TB
  • Disseminated TB
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3
Q

What is another word for primary TB?

A

Primary infection stage

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4
Q

Primary TB follows the pt’s

A

first exposure to the TB pathogen, Mycobacterium TB

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5
Q

A rod shape bacterium w/ a waxy capsule is called

A

Mycobacterium TB

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6
Q

Primary TB begins w/ the

A

inhaled bacili implant of the alveoli

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7
Q

What is the name for the protective cell wall that the lung tissues surrounds?

A

tubercle or granuloma

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8
Q

The tubercles work to

A

encapsulate or trap the TB, in a nut shell structure

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9
Q

The initial lung lesion on a chest radiograph is called

A

Ghon nodules

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10
Q

The combination of tubercles and the involvement of the lymph nodes in the hilar region is known as the

A

Ghon complex

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11
Q

Tubercle consists of a central core containing caseous necrosis and TB bacilli also called (2)

A
  • caseous lesion
  • caseous granuloma
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12
Q

Bacilli can multiple over a

A

3- 4 week period

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13
Q

A tubercle takes about

A

2- 10 weeks to form

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14
Q

The function if the tubercle is to

A

contain the TB bacilli and prevent from spreading

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15
Q

Once the bacilli are controlled the healing process begins. What replaces the tubercle?

A

Tissue fibrosis and classification of the lung parenchyma

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16
Q

In some cases, the classification and fibrosis cause the bronchi to distort and

A

dilate, this is to cause bronchiectasis

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17
Q

When the bacilli are isolated within the tubercle, the TB remains _________ for months, years or life

A

dormant

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18
Q

People with _______ TB (or _______ TB)do not feel sick or have any TB- related symptoms

A
  • dormant (latent )
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19
Q

This is a term that is used to describe the reappearance of TB months or even years after the initial infection has been controlled

A

Reactivation TB

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20
Q

What is another name for for reactivation TB (3)

A
  • postprimary TB
  • reinfection TB
  • secondary TB
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21
Q

Most reactivation TB cases are associated in pts w/ the following

A
  • Malnourished individuals
  • Ppin Institutional housing
  • Ppl living in overcrowded conditions
  • Immunosuppressed pts
  • HIV
  • Alcohol abuse
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22
Q

What is the leading cause of death in pts w/ HIV

A

TB

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23
Q

Refers to infection from TB bacilli that escapes from a tubercle and travel to other sites throughout the body by means of bloodstream or lymphatic

A

Disseminated TB

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24
Q

Other names for disseminated TB (3)

A
  • extra pulmonary TB
  • military TB
  • TB disseminated
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25
Q

TB that enter the body by means of the bloodstream usually gather and multiply in portions of the body that have

A

higher tissue oxygen tension

26
Q

The most common location for TB to gather and multiply is the

A

apex of the lungs

27
Q

Other oxygen rich area in the body include:

A
  • the regional lymph nodes
  • kidneys
  • long bones
  • genital tract
  • brain
  • meninges
28
Q

The major pathologic stuctual changes in TB ( moderate to severe reactivation)

A
  • Alveolar consolidation
  • Alveolar- capillary membrane destruction
  • Caseous tubercles or granulomas
  • Cavity formation
  • Fibrosis and secondary calcification of lung parenchyma
  • Distortion and dilation of the bronchi
  • Increased bronchial secretions
29
Q

In ancient times TB was often called

A
  • “consumption”
  • “Captain of the Men of Death”
  • the white plague
30
Q

WHO reported the TB is one of the top ___ causes of death worldwide

A

10

31
Q

In human cases TB is primarily caused by

A

Mycobacterium TB

32
Q

What is the transmission of TB caused by?

A

Aerosol droplets produced by coughing, sneezing, or laughing of an individual w/ active TB

33
Q

It has been shown that in very fine aerosolized spray droplets (0.5 to 1.0), the TB bacilli can remain suspended in the air for

A

several hours after a cough or a sneeze

34
Q

Along with chest radiology, these methods are also used to diagnose TB

A
  • Mantoux tuberculin skin test
  • acid- fast bacilli (AFB) sputum cultures
  • QuantiFERON-TB Gold test (QFT-G)
  • rapid Xpert MTB/RI assay
35
Q

The most widely used tuberculin test is the

A

Mantoux test

36
Q

Mantoux test consists of an intradermal injection of a small amount of

A

purified protein derivative (PPD) of the tuberculin bacillus

37
Q

After the PPD, the skin is observed for

A

induration ( a wheal) after 48- 72 hours

38
Q

An induration test of less than ___ mm is a _________ test

A

5, negative

39
Q

An induration of ___ to ___ mm is considered ____________ and ____________ is required

A

5 to 9
suspicious
retesting

40
Q

An induration of ____ mm or greater is considered __________

A

10, positive

41
Q

Positive reaction does not mean that the pt has active TB but only the pt has been

A

exposed to the bacillus and has developed latent TB

42
Q

Because m.TB has an unusual waxy coating on the cell surface, which the cell impervious to staining, an

A

acid-fast bacteria test ( sputum smear) is performed instead

43
Q

The frequently used

A

Ziehl- Neelsen stain reveals a bright red AFB against a blue background

44
Q

This technique revels luminescent yellow- green bacilli against a dark brown background

A

fluorescent acid- fast stain

45
Q

The fluorescent acid- fast stain is becoming more popular b/c it is

A

easier to read

46
Q

Sputum cultures is often necessary to differentiate

A

M. TB from other acid- fast organisms

47
Q

B/c polycythemia and cor pulmonale are associated with severe TB the following may be seen

A
  • Distended neck veins
  • Pitting edema
  • Enlarged and tender liver
48
Q

Chest Assessment findings (fluid)

A
  • Increased tactile and vocal fremitus
  • Dull percussion note
  • Bronchial breath sounds
  • Crackles, wheezing
  • Pleural friction rub (if extends into the pleural surface)
  • Whispered pectoriloquy
49
Q

Abnormal Lab Test and Produce results

A
  • Positive PPD
  • Positive sputum acid-fast bacillus (AFB) stain test
  • Positive ABF sputum culture
  • Positive QuantiFERON- TB Gold Test
50
Q

Radiologic Findings

A
  • Increased opacity
  • Ghon nodule
  • Ghon complex
  • Cavity formation
    Cavitary lesion containing an air- fluid level
  • Pleural effusion
  • Calcification and fibrosis
  • Retraction of the lung segments or lobe
  • Right ventricular enlargement
51
Q

The standard pharmacological agents to treat M. TB consists of

A

two to four drugs for 6 to 9 months

52
Q

Questions from the back
What are the first stage of TB

A
  • Primary TB
  • Primary infection stage
53
Q

What is the name of the protective wall that surrounds and encases lung tissue infected w/TB?

A
  • Granuloma
  • Tubercle
54
Q

The tubercle bacillus is

A
  • Highly aerobic
  • Acid fast
  • Capable of surviving for months outside the body
  • Rod-shaped
55
Q

At which stage is a tuberculin skin test considered to be positive

A

Greater than 10 mm

56
Q

What is often prescribed as a prophylactic daily dose for 1 year in individuals who have been exposed to TB bacilli

A

Isoniazid

57
Q

What are the first line agents prescribed for the entire 9 months?

A
  • Isoniazid
  • Rifampin (Rifadin)
58
Q

Six month treatment protocol: For the first 2 months (induction phase) the pt takes a daily dose of

A
  • isoniazid (INH)
  • rifampin (RIF)
  • pyrazinamide (PZA)
  • either ethambutol (EMB, E) or streptomycin (SM)
59
Q

In noncompliance pts, it is recommended that TB be treated by

A

directly observed therapy (DOT),

60
Q

The ingestion of medications is directly observed by a responsible individual

A

DOT

Cadiopulmonary Medicine (24 decks)

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