Tuberculosis Flashcards
How does cell mediated immunity limit the spread of primary TB?
Granuloma forms
What are some risk factors for reactivation of TB?
HIV Organ transplant Prolonged therapy with corticosteroids Severe kidney disease/ haemodialysis DM Silicosis low body weight Tumour necrosis factor alpha antagonists
What is the gold standard for TB diagnostics?
TB culturing
Why may you get false negatives in TST?
Why may you get false positives?
Immunocompromised, HIV, drug usage etc
BCG vaccination and NTB
What is an advantage of using IGRAs compared to TST?
No cross-reaction with BCG as only detects MTB.
Name the first line medication for TB?
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol
What may you supplement patients with in TB?
Vitamin D
What are 2 ADRs of rifampicin?
Raised transaminases and induction of cytochrome P450
orange secretions
Which 2 first line TB drugs cause hepatotoxicity?
Which one causes visual disturbance?
Which one causes peripheral neuropathy?
Isoniazid
Pyrazinamide
Ethambutol
Isoniazid
How should the medications be administered?
3/4 drugs for 2 months
R and I for 4 months
18 months if CNS TB
How can you ensure adherence of pt to Tx?
Directly observed therapy
Video observed therapy
What is MDR TB resistant to?
XDR?
Rifampicin and isoniazid
Fluroquinolones and at least 1 injectable
What is the Tx for MDR TB?
Quinolones Aminoglycosides PAS Cyclosporine Ethionamide
QAPCE
18 months
What may be seen on fundoscopy of someone with military TB?
Choroid tubercles
Give some manifestations of extra-pulmonary TB?
Lymphadenitis (scrofula) Peritoneal (ascites) Genito urinary (renal disease) Spinal TB Potts disease (tuberculous spondylitis) Tuberculous meningitis
