Tuberculosis Flashcards
Strongest known risk factor for developing TB.
What’s the estimated relative risk?
Any other risk factors?
HIV
20
Age, DM, ETOH, Smoking, malnutrition
TB Lymphadenitis main ddx
What’s characteristic of TB?
Lymphoma, HIV
Rubbery, non-tender, necrotic area allowing aspiration, asymmetrical, paradoxical enlargement with treatment
True or False: Two sputum specimens obtained in the clinic are as sensitive as two samples taken on separate days
True
True or False: The concentration of bacteria in a smear gives a guide to burden of disease and infectivity of the patient
True
Which diagnostic method is the gold standard for TB?
Culture - but takes several weeks
What else can original geneXpert tell you other than a diagnosis of TB?
Resistance to Rifampicin
Pros of GeneXpert?
Rapid, does not require technical experties
Other types of geneXpert?
Ultra : higher sensitivity
Omni: Battery operated
Side effects: R, INH, Z
Liver dysfunction, rash, GI upset
Side effects: Rifampicin, RifaPentin
Major drug interaction including OCP
Side effects: INH
What reduces its risk?
Peripheral neuropathy
Vit B6
Side effect: Pyrazinamide
Arthralgia
Side effect: Ethambutol
Optic neuropathy (Careful with kidney disease)
MDR TB definition
Resistance to Rifampicin and Isoniazid
Pre- XDR TB
MDR + flouroquinolone
XDR TB:
MDR + fluoroquinolone + at least one Group A drug (Bedaquiline & Linezolid)
Risk factors for MDR-TB
- Contact of a known case of MDR TB
- Previous drug treatment for TB
- Poor adherence to previous treatment
- Birth or residence in a country with WHO-reported incidence of =/> 5% of new cases
Treatment MDR-TB
3A +1B
(levofloxacin OR moxifloxacin) OR bedaquiline OR linezolid + clofazimine OR cycloserine OR terizidone
For 20 months
Which TB drug should you be worried about giving to a patient on OCP?
Rifampicin
