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SU18: Internal med final > Tuberculosis > Flashcards

Tuberculosis Flashcards

1
Q

T/F: TB is the 2nd most common cause of infectious deaths worthwide

A

true

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2
Q

how much of the world population is estimated to be infected with latent TB?

A

1/3rd

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3
Q

TB vaccine

A

Bacille Calmette-Guerin (BCG)

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4
Q

what bacteria causes TB?

A

mycobacterium tuberculosis

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5
Q

how is TB spread?

A

via inhalation of infected droplets

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6
Q

what happens when TB is deposited in the lungs?

A
  1. immediate clearance of organism
  2. primary disease
  3. latent infection
  4. reactivation disease
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7
Q

what percentage of ppl who have deposition of the bacteria in their lungs resulted in primary disease?

A

5-10%

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8
Q

what percentage of ppl with deposition of the bacteria in the their lungs are asymptomatic?

A

90%

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9
Q

what are the syms of primary disease?

A

same syms as infectious disease

* fever, malaise, etc

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10
Q

what is the occurance rate of the disease reactivating?

A

5-10%

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11
Q

latent infection

A

bacteria still replicating but the body walls them off in granuloma
- does not cause syms

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12
Q

clinical manifestations of pulmonary TB

A
  • cough >2-3 wks duration
  • lymphadenopathy
  • fevers
  • night sweats
  • weight loss
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13
Q

epidemiologic factors of pulmonary TB

A
  • history of prior TB infection
  • known TB exposure
  • residence or travel to areas where TB is endemic
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14
Q

diagnosis of pulmonary TB

A
  • 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
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15
Q

is tuberculin skin test a confirmation of disease?

A

NO, not complete firm positive

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16
Q

tuberculin skin test

A
  • delayed hypersensitivity response

- induration >24 hrs later

17
Q

positive individuals of tuberculin skin test

A
  • infection w/ non-tuberculosis mycobacteria
  • previous BCG vaccination
  • previous infection w/ M. tuberculosis
18
Q

international standards for tuberculosis management

A
  • prompt diagnosis
  • standard chemotherapeutic txtment regimens
  • supervised txtment
  • monitored txtment response
  • public health measures
19
Q

what are the goals of the standard chemotherapeutic txtment regimens?

A
  1. eradicate infection
  2. prevent transmission
  3. prevent relapse
20
Q

what are the two phase of drug therapy for TB?

A
  1. intensive phase

2. continuation phase

21
Q

how long is the intensive phase?

A

2 months of daily dosing

22
Q

what drugs are taken during the intensive phase?

A
  • isoniazid
  • rifampin
  • pyrazinamide
  • ethambutol
23
Q

how long is the continuation phase?

A

4-7 months of daily dosing

24
Q

what drugs are taken during the continuation phase?

A
  • isoniazid

- rifampin

25
Q

completion of chemotherapeutic therapy is determined by?

A

having 2 consecutive negatives of sputum culture

26
Q

what percentage of compliant pts become non-infectious within first 3 months?

A

90%

27
Q

effective chemotherapy

A
  • pt education and compliance
  • appropriate drug selection
  • multiple drug use
  • sufficient length of course
28
Q

what is a reason for reactivation of disease?

A

pts are not compliant with meds

29
Q

can you treat a pt with active pulmonary infection?

A

no elective outpatient dental txtment

30
Q

txtment for active pulmonary infection

A
  • airborne isolation in hospital setting

- TB drug regimen

31
Q

which TB drugs are hepatotoxic?

A
  • isoniazid
  • rifampin
  • pyrazinamide
32
Q

which TB drugs are thrombocytopenia and leukopenia?

A

rifampin

33
Q

if pt was previously treated for TB, would they have positive tuberculin skin test from now on?

A

yes, will always have a positive skin test

*once have hypersensitivity rxn, will always be positive

34
Q

can you treat a pt with a positive tuberculin skin test?

A

yes

35
Q

mods to dental txtment

A

following universal precautions is adequate

36
Q

dental offices are considered what type of risk for occupational exposure according to the CDC?

A

low

SU18: Internal med final (25 decks)

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