Tuberculosis Flashcards
Most important risk factor for progression of latent TB to active TB
HIV - risk is 10% per year
Others -smoking, diabetes, low body wt, genetic
Greatest risk - in 1st 2 years
TST -type of reaction
Delayed hypersensitivity reaction
IL-8, INF gamma, TNF alpha
IGRA in TB
Cannot differentiate between active and latent TB
Stays positive even in treated TB
Negative IGRA does not exclude TB
S/E TB drugs
INH- Rash, hepatitis, neuropathy
Rifampicin -Drug interactions, hepatitis
Pyrazinamide -Hepatitis, gout
Ethambutol - optic neuropathy
Most common drug resistance in TB
INH
Which drug resistance indicative of MDR TB
Rifampicin, INH
HIV Drugs and TB
Tenofovir alafeamide contraindicated with Rifampicin
TDF -ok
Rifampicin contraindicated with PI - Low dose Rifabutin used
NNRTI -efavirens ok with Rifampicin
Raltegravir, Doloutegravir - double dose with Rifampicin, usual dose with Rifabutin
ART timing in HIV with TB
If CD4 0-50 -early ART - IN 2 weeks (Except in TB meningitis -wait 8 weeks)
CD4 >50 - Commence ART 8 wks after starting TB Rx
Resistance pattern with XDR TB
INH + Rifampicin + Fluoroquinolones + Injectable (kanamycin/capreomycin/amikacin)
Bedaquiline in TB
ATP synthetase inhibitor, reduced time to sputum conversion
Delaminid
Nitro-dihydro-imidazooxazole, inhibitis mycolic acid synthesis, added to background MDR regimen
Latent TB treatment
INH for 9 months OR
Weekly Rifapentine + INH for 12 weeks
Victoria- Patient presenting with skin ulcer, culture negative, Bx-granuloma
Mycobacterium ulcerans
