Tuberculosis Flashcards
Where does tuberculosis occur on an Xray?
upper lobes
TB Skin Test Induration: HIV or immunocompromised
> 5, anything greater than 5mm
TB Skin Test Induration: general public
> 15, anything greater than 15mm
TB Skin Test Induration: recently immigrated
> 10, anything greater than 10mm
TB Skin Test Induration: healthcare worker exposed to TB
> 5
TB Skin Test Induration: healthcare worker, no exposure
> 10
If patient recently immigrated and has a positive induration greater than 10 but has no symptoms what would the next best step be?
Order a chest X ray
since they currently have no symptoms then we are going to check for a past exposure with a chest x ray. if they had symptoms (fever, chills etc) then you would order a sputum culture.
At what CD4 count does HIV turn into AIDS?
CD4 < 200
How do we confirm TB diagnosis?
sputum culture
Induration of 5 mm or more is considered positive in:
Recent contact with an infectious person
Persons with HIV
Persons with chest x-ray findings suggestive of TB
Persons with organ transplants
Immunosuppressed persons, such as those taking prolonged corticosteroid therapy (15 mg or more per day of prednisone) or TNF-a antagonists like etanercept (Enbrel)
Induration of 10 mm or more is considered positive in:
Persons born in countries with high rates of TB (e.g., Mexico, Philippines, Vietnam, China, Haiti, Guatemala)
Drug abusers
Workers in high-risk settings (e.g., nursing homes, homeless shelters, correctional facilities)
Persons with certain medical conditions (e.g., silicosis, diabetes, severe kidney disease, certain types of cancer, Crohn disease)
Persons with low-body weight (<90% of ideal body weight)
Infants, children, and adolescents exposed to high-risk categories
Induration of 15 mm or more is considered positive
in people with no risk factors.
