Tuberculosis Flashcards
T/F: TB is the 2nd most common cause of infectious deaths worthwide
true
how much of the world population is estimated to be infected with latent TB?
1/3rd
TB vaccine
Bacille Calmette-Guerin (BCG)
what bacteria causes TB?
mycobacterium tuberculosis
how is TB spread?
via inhalation of infected droplets
what happens when TB is deposited in the lungs?
- immediate clearance of organism
- primary disease
- latent infection
- reactivation disease
what percentage of ppl who have deposition of the bacteria in their lungs resulted in primary disease?
5-10%
what percentage of ppl with deposition of the bacteria in the their lungs are asymptomatic?
90%
what are the syms of primary disease?
same syms as infectious disease
* fever, malaise, etc
what is the occurance rate of the disease reactivating?
5-10%
latent infection
bacteria still replicating but the body walls them off in granuloma
- does not cause syms
clinical manifestations of pulmonary TB
- cough >2-3 wks duration
- lymphadenopathy
- fevers
- night sweats
- weight loss
epidemiologic factors of pulmonary TB
- history of prior TB infection
- known TB exposure
- residence or travel to areas where TB is endemic
diagnosis of pulmonary TB
- pt’s meeting clinical criteria/history… get chest radiography if suggestive then
- 3 sputum specimens to run for isolation of M. tuberculosis
- tuberculin skin test as an adjunct
is tuberculin skin test a confirmation of disease?
NO, not complete firm positive
tuberculin skin test
- delayed hypersensitivity response
- induration >24 hrs later
positive individuals of tuberculin skin test
- infection w/ non-tuberculosis mycobacteria
- previous BCG vaccination
- previous infection w/ M. tuberculosis
international standards for tuberculosis management
- prompt diagnosis
- standard chemotherapeutic txtment regimens
- supervised txtment
- monitored txtment response
- public health measures
what are the goals of the standard chemotherapeutic txtment regimens?
- eradicate infection
- prevent transmission
- prevent relapse
what are the two phase of drug therapy for TB?
- intensive phase
2. continuation phase
how long is the intensive phase?
2 months of daily dosing
what drugs are taken during the intensive phase?
- isoniazid
- rifampin
- pyrazinamide
- ethambutol
how long is the continuation phase?
4-7 months of daily dosing
what drugs are taken during the continuation phase?
- isoniazid
- rifampin
completion of chemotherapeutic therapy is determined by?
having 2 consecutive negatives of sputum culture
what percentage of compliant pts become non-infectious within first 3 months?
90%
effective chemotherapy
- pt education and compliance
- appropriate drug selection
- multiple drug use
- sufficient length of course
what is a reason for reactivation of disease?
pts are not compliant with meds
can you treat a pt with active pulmonary infection?
no elective outpatient dental txtment
txtment for active pulmonary infection
- airborne isolation in hospital setting
- TB drug regimen
which TB drugs are hepatotoxic?
- isoniazid
- rifampin
- pyrazinamide
which TB drugs are thrombocytopenia and leukopenia?
rifampin
if pt was previously treated for TB, would they have positive tuberculin skin test from now on?
yes, will always have a positive skin test
*once have hypersensitivity rxn, will always be positive
can you treat a pt with a positive tuberculin skin test?
yes
mods to dental txtment
following universal precautions is adequate
dental offices are considered what type of risk for occupational exposure according to the CDC?
low
