Tuberculosis Flashcards

1
Q

Define TB and the likely pathogen

A

Communicable infectious disease caused by Mycobacterium Tuberculosis which produces silent , progressive active disease

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2
Q

Etiology of TB

A

Caused by Mycobacterium Tuberculosis =bacilli
Immunocompromised high risk
M. TB spread through micro size droplet nuclei through sneezing and coughing
Patients with laryngeal TB- increased risk when talking

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3
Q

Pathophysiology tb

A

Immune system identify M. Tuberculosis
And trigger macrophages and T-lymphocyte(CD4 and CD-8). TB is phagocytoses by alveolar macrophages , trigger recruitment of T-lymphocyte , formation of granuloma to contain infections and prevent spread , leading to latent TB .patient is asymptomatic but if Immunocompromised reactivation can occur lead to active TB

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4
Q

Signs and symptoms tb

A

Cough, weight loss ,night sweats, fatigue, fever
Bacteria can spread leading to extra pulmonary TB

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5
Q

Describe extra pulmonary TB

A

Affects other organs and tissues
Ie
Lymph nodes-lymphadenitis
Bones and joint-skeletal TB
Genitourinary-renal TB , genital TB
CNS -meningitis
Pericardium-pericardial
Skin and soft tissue -cutaneous TB

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6
Q

Diagnosis?tb

A

Sputum smear microscopy-acid -fast bacilli staining/smear
Microbiology, sputum:culture and sensitivity
GeneXPert-diagnose TB and resistance to rifampicin
Chest X ray
Clinical presentation

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7
Q

Give indication for culture and DST (tb)

A

All children
Symptomatic individuals at high risk of MDR-TB ie lab workers
Patients suspected of cryogenic TB
Relapse patient
HIV positive with 2 negative smears

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8
Q

Diagnosis for paediatric(tb)

A

Chest X-ray
Tuberculin skin test(TST) -purified protein derivative (PPD)
Microscopy and culture to collect sputum from child you can do induced sputum collection, saliva induction through like lemon juice

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9
Q

Risk factors for TB

A

HIV status and Immunocompromised
Comorbidities-DM, alcoholism,malnutrition
Prolonged treatment with steroids
History TB
Exposure to pt with pulmonary TB
Males and being black
Children <5 years

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10
Q

Risk factors for paediatric tb

A

History of recent contact with TB case
Age<3years
Malnutrition
Immune status
Time since exposure ie likely develop within 1 year

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11
Q

Goal of management of TB

A

Early collection of specimen
Initiate appropriate regimen
Isolation patient with active disease
Prevent TB transmission
Restore quality of life
Resolution of symptoms

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12
Q

Non pharmacological management tb

A

Isolation to prevent spread
Contact tracing
Replenishment >normal weight

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13
Q

1st line management of TB

A

RIPE(HRZE)
1. HRZE for 2 months initial phase then HRE for 4 months continuation phase
H-isoniazid - 10mg/kg daily
R-rifampicin-15mg /kg daily
Z-Pyrazinamide-35mg/kg daily
E-ethambutol-20mg/kg daily
S-streptomycin -15mg/kg daily

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14
Q

Management of relapse, treatment failure tb

A
  1. HRZES for 2 months and , HRE for 5 months
  2. 1 month HRZE and HRE 5 months
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15
Q

Paediatric regimen tb

A

<30kg : 2HRZE/4 HR
>30kg 2HRZE/4HRE
Retreat: 2HRZES/5HRE

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16
Q

Isoniazid is always paired with?

A

Pyridoxine vitamin B6

17
Q

Compare ethambutol and streptomycin

A

E-inhibit synthesis of bacterial cell wall
S-bind 30s ribosome prevent protein synthesis
Admin -E -oral S-IM
S/E - E -optic neuritis so regular eye exams
S-ototoxic and nephrotoxic check liver function test and ear test
R-discoloration of urine, tears, GIT upset, flulike symptoms ie fever , chills, hepatotoxicity
H- hepatotoxicity, peripheral neuropathy, rash, CNS effects ie seizures
Z-rash, git upset, hepatotoxicity, hyperuricemia(gout), arthralgia(joint pain)