Tuberculosis Flashcards
what causes TB?
Mycobacterium TB- aerosol droplets
how many people will develop dz?
most exposed will mount an immune response that is sufficient to prevent progression
but 10% will- “Primary TB”
what happens when a person can’t contain the primary infxn?
progresses to active TB w/in 2 yrs
“progressive primary TB”
what is a “latent TB infx”?
“LTBI”
those that contain the
bacterium w.o become infected-
they are not considered to be infx, nor can they spread the dz
where is inactive TB most commonly found in the body?
apices of the lung
what is “reactivation TB”?
develops from LTBI in the setting of immune compromise
what is the most common sx of TB>
cough
dry cough and progesses to a productive cough
+/- hemoptysis that last longer than 3 wks
what are other sx?
cough, pleuritis chest pain, fever, night sweats, anorexia, weight loss
**posttussive rales
how might the pt appear?
chronically ill and malnourished
Laboratory findings of primary TB
homogenous inflitrates, hilar/paratracheal lymph node enlargement, segmental atelectasis, cavitations w/ progressive dz
XR or reactivation TB
fibrocavitary apical dz, nodules, infiltrates, posterior and apical segments of the Right upper lob, apical-psterior segments of the left upper lob, superior segments of the lower lobs
healed primary infx show what on the xra?
ghon and ranke
ghon complexes
calcified primary focus
Ranke complexes
calcified primary focus and calcified hilar lymph nodes
PPD?
reported accourding to the diameter of INDURATION
ppd read?
> 15mm-pts w/ no rf for tb
> 5mm-pts w/ active HIV
definitive dx of TB
identification of myco. TB from cultures or b by DNA/RNA amplification techniques
what is the histologic hallmark?
bx revealing caseating granulomas
how do you tx TB?
isoniazid
rifampin
pyrazinamide
ethambutaol
ADR of isoniazid?
hepatitis, peripheral neuropathy
*coadminister vit B6 to reduce risk
ADR of rifampin?
hepatitis, flu syndrome, orange body fluid
ADR of ethambutaol
optic neuritis
how long to you tx ps w/ active dx for?
6-9 mnts, pts w/ HiV requires at least a year
what is the bacille Calmette-Guerin vaccine?
use in aread where TB is endim
what about kids and immunocompromised that have been in close contact w. active TB?
offer tx until TST is neg 12 wks after exposure
