Tuberculosis Flashcards
What is the organism responsible for tuberculosis?
Mycobacterium tuberculosis
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 481.
Why does the organism responsible for tuberculosis
infect the apices of the lungs preferentially?
The organsism responsible for tuberculosis (Mycobacterium
tuberculosis) requires high oxygen concentrations to thrive.
Because of the natural tendency of oxygen to maintain higher
concentrations in the superior portion of the lung, tuberculosis
has an increased incidence in the apices.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 481.
What are the most common symptoms of
tuberculosis?
Nonproductive cough, hemoptysis, night sweats, chest pain,
and weight loss.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 481-482
What types of patients exhibit the highest incidence
of tuberculosis?
Foreign-born persons from areas where the disease is
prevalent (Africa and Asia), intravenous drug abusers, and
patients with AIDS.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 481-482.
What is the most common test used to diagnose
tuberculosis and what are its limitations? What tests
are more reliable for diagnosing TB?
The tuberculin skin test (Mantoux test) is the most common test
used to diagnose TB. The test may inaccurately report positive
if the patient has been exposed but not infected with TB, has
received a bacille Calmette-Guerin vaccine, or been exposed to
other species of Mycobacterium, even if there is no bacterial
infection at the time of testing. Chest radiographs and sputum
smears are more accurate in diagnosing TB.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 481
How effective is current medical therapy in the
treatment of tuberculosis?
Although multi-drug resistant strains of tuberculosis are
beginning to result in a resurgence in the incidence of TB,
current medical therapy results in a negative sputum smear in
90% of patients within 3 months.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 481.
What chest ray findings are associated with
tuberculosis?
Tuberculosis is associated with chest xray findings such as
bilateral upper lobe infiltrates (often with cavitation), apical and
subapical infiltrates, and vertebral osteomyelitis (Pott’s disease)
which is common in advanced extrapulmonary tuberculosis.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 482.
What airway and respiratory considerations should
you be aware of when caring for a patient with
tuberculosis?
If tuberculosis of the cervical spine is present, airway
management should proceed cautiously to prevent injury.
Patients with tuberculosis need to have a high efficiency
airborne particulate filter placed between the patient and the
anesthesia circuit. During transport, the patient must wear a N-
95 filter mask. During surgical procedures, all healthcare
workers in the operating room must also wear N-95 masks.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 482.
Rifampin is a drug used in the treatment of
tuberculosis. What are some of the serious side
effects of this drug?
Thrombocytopenia, leukopenia, anemia, renal failure, and
hepatic failure.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 482
Isoniazid is used in the treatment of tuberculosis.
What are some of the more serious side effects of
this drug?
Isoniazid is toxic and can result in damage to the liver,
peripheral nervous system, and kidneys.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 482.
A patient with old pulmonary tuberculosis is about to
undergo general anesthesia. What concerns do you
have regarding spontaneous versus positivepressure
ventilation?q
Positive-pressure ventilation can result in massive hemoptysis
in patients with long-standing pulmonary TB. Many practitioners
prefer to employ spontaneous ventilation if at all possible to
reduce the risk of hemoptysis.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 482.
