Tuberculosis Flashcards
essentials of DX for What?
(1) Fatigue, weight loss, fever, night sweats, productive cough.
(2) Cough >2 to 3 weeks’ duration, lymphadenopathy.
(3) Risk factors: Household exposure, incarceration, drug use, travel to endemic area.
(4) Chest Radiograph: Pulmonary opacities.
(5) Acid-fast bacilli on smear of sputum or sputum culture positive to confirm Mycobacterium tuberculosis.
TB.
True/False
The lungs are the major site for Mycobacterium tuberculosis primary infection and tuberculosis (TB) disease.
True
True/False
Clinical manifestations of TB include primary TB, reactivation TB, laryngeal TB, endobronchial TB, lower lung field TB infection, and tuberculoma
True
True/False
Pulmonary complications of TB don’t include hemoptysis, pneumothorax, bronchiectasis,
extensive pulmonary destruction, malignancy, and chronic pulmonary aspergillosis.
False
Can include…
Physical findings of pulmonary TB are not specific and usually are absent in mild or moderate disease. Early onset symptoms are similar to______.
Pneumonia
Dullness with decreased fremitus may indicate _______ or _______.
pleural thickening or effusion
Distant hollow breath sounds over cavities are called _______.
named after the sound made by blowing across the mouth of jars used in antiquity.
amphoric
TB Physical Findings
Crackles may be present throughout _____ or may be heard only after a short cough
- inspiration
- exhalation
inspiration
True/False
When large areas of the lung are involved, signs of consolidation associated with open bronchi, such as whispered pectoriloquy or tubular breath sounds,
may be heard
True
TB Labs
Acid fast bacilli light microscopy- Require ____ consecutive morning specimens. Most labs are normal in the setting of pulmonary TB.
3 consecutive morning specimens
Most patients with ________TB have abnormalities on chest radiography, even in the absence of respiratory symptoms. _______ TB typically involves the apical posterior segments of the upper lobes (80 to 90 percent of patients).
reactivation
TB labs
Sputum should represent secretions from the lower respiratory tract,
How much is needed to obtain a diagnostic yield?
at least 5 to 10 mL
what are some ddx for TB
(1) Pneumonia
(2) Cystic Fibrosis
(3) Chronic Bronchitis
What meds are used to treat TB
Isoniazid
Rifampin
What is the Dosing for Isoniazid?
5 mg/kg/dose (usual dose: 300 mg) once daily.
Note:
The preferred frequency of administration is once daily during the intensive and continuation phases; however, 5-days per week administration by directly observed therapy (DOT) is an acceptable alternative.