Tuberculosis Flashcards

1
Q

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.

A

TB.

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2
Q

True/False
The lungs are the major site for Mycobacterium tuberculosis primary infection and tuberculosis (TB) disease.

A

True

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3
Q

True/False
Clinical manifestations of TB include primary TB, reactivation TB, laryngeal TB, endobronchial TB, lower lung field TB infection, and tuberculoma

A

True

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4
Q

True/False
Pulmonary complications of TB don’t include hemoptysis, pneumothorax, bronchiectasis,
extensive pulmonary destruction, malignancy, and chronic pulmonary aspergillosis.

A

False
Can include…

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5
Q

Physical findings of pulmonary TB are not specific and usually are absent in mild or moderate disease. Early onset symptoms are similar to______.

A

Pneumonia

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6
Q

Dullness with decreased fremitus may indicate _______ or _______.

A

pleural thickening or effusion

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7
Q

Distant hollow breath sounds over cavities are called _______.
named after the sound made by blowing across the mouth of jars used in antiquity.

A

amphoric

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8
Q

TB Physical Findings
Crackles may be present throughout _____ or may be heard only after a short cough

  1. inspiration
  2. exhalation
A

inspiration

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9
Q

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

A

True

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10
Q

TB Labs
Acid fast bacilli light microscopy- Require ____ consecutive morning specimens. Most labs are normal in the setting of pulmonary TB.

A

3 consecutive morning specimens

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11
Q

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).

A

reactivation

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12
Q

TB labs
Sputum should represent secretions from the lower respiratory tract,
How much is needed to obtain a diagnostic yield?

A

at least 5 to 10 mL

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13
Q

what are some ddx for TB

A

(1) Pneumonia
(2) Cystic Fibrosis
(3) Chronic Bronchitis

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14
Q

What meds are used to treat TB

A

Isoniazid
Rifampin

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15
Q

What is the Dosing for Isoniazid?

A

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.

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16
Q

What is the adverse effects of INH

A

> 10%: Hepatic, toxicity, increased serum transaminases

17
Q

What other med should you give a pt with INH and what labs should they have done?

A

Vitamin B6- 50mg daily with INH dose

Liver Function Test should be performed prior to
initiating and then situational depending on patients response to INH therapy

18
Q

What are contraindications for IHN

A

-Drug-induced hepatitis;
-acute liver disease
-previous hx of hepatic injury during isoniazid therapy
-previous severe adverse reaction

19
Q

What is the dosage for Rifampin

A

300 mg PO BID

20
Q

Treatment regimens for pulmonary tuberculosis and tuberculous meningitis

A

-initial 2-month phase of a 4-drug regimen followed by a continuation phase

-continuation phase of an additional 4 to 7 months of rifampin and isoniazid for pulmonary tuberculosis

-continuation phase of an additional 7 to 10 months of rifampin and isoniazid for tuberculous meningitis

21
Q

Complications of TB

A

Death
Transmission of the disease via air or sputum