Tuberculosis Flashcards
Types of tests to confirm TB diagnosis?
skin test/mantoux test (forearm) + chest xray –> if positive results, but no symptoms, then inactive TB and requires prophylaxis.
Prophylactic tx for TB?
INH for 9 months
What are the three uses for the Mantoux test?
- diagnosis of latent TB infection
- assisting in the diagnosis of TB
- epidemiological tool
If a patient has known or suspected TB, should they go to emergency treatment?
yes, hospitalized in a single negative pressure room, placed on respiratory precautions.
What are the skin test results?
> 5 mm = HIV + Recent contact with active TB, immunocompromised
> 10 mm = residents, employees of long-term care facilities, IVDU, recent immigrants < 5 yrs
> 15 mm = general public without known risk factors
What can be the cause of a false negative test?
secondary ill patients, those with impaired cell mediated immunity, inappropriate technique/reading
What can be the cause of a false positive test?
history of BCG vaccination, exposure to non-TB mycobacteria, inappropriate technique reading
What is the latent TB state?
inactive stage, pt is infected, but not contagious so it cant spread
what is the treatment in latent TB?
isoniazid QD or twice weekly for 9 months.
if INH resistant, give Rifampin qd for 4 months
symptoms of active TB?
cough, fever, night sweating, weight loss
how is TB spread?
Lungs - chest pain, coughing up blood, productive cough, prolonged cough
Central - appetite loss, wt loss, fatigue, fever
Skin - night sweats, pallor
in patients with TB, what drugs should be avoided?
Live vaccines, TNF alpha inhibitors
Treatment for active TBÉ
- INH
- if INH resistance > 4% = INH + Rifampin + PZA + Ethambutol
- if INH resistance < 4% = INH + Rifampin + PZA
- if no resistance, INH + Rifampin + ethambutol
Drugs of choice if rifampin resistant?
INH + PZA + EM + a quinolone or Streptomycin
Drug therapy in elderly > 65 or if at risk of hepatotoxicity?
INH + RIFAMPIN + ETM qd x 2 months, then INH + Rifampin daily x 7 months
