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PEDIATRICS 2 > Tuberculosis in Children > Flashcards

Tuberculosis in Children Flashcards

1
Q

First effective drug used for tuberculosis

A

Streptomycin

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2
Q

Primary complex with effective treatment can heal by:

A

scar, fibrosis, and calcification

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3
Q

3 Major clinical states of tuberculosis

A

Exposure
Tuberculous infection
Disease

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4
Q

This means that a child had a significant contact with an adult or adolescent with infectious tuberculosis but lack proof of infection

A

Exposure

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5
Q

This is the hallmark of the clinical stage TBI (Tuberculosis Infection)

A

(+) Tuberculin Skin Test or Interferon-gamma release assay

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6
Q

This is the stage when signs or symptoms or radiographic manifestations caused by M. tuberculosis becomes apparent

A

Tuberculosis Disease

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7
Q

The transmission of TBB is usually through:

A

Airborne droplets

via coughing, sneezing, talking

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8
Q

Children with MTB infection is unable to transmit or rarely transmits the bacteria since the lung lobe/s involved in a child is typically:

A

middle and lower lobe

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9
Q

An adult/adolescent with TB becomes non-communicable after how many weeks of standard treatment initiation?

A

3 weeks

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10
Q

Where does incubation occur after inhalation of MTB ?

A

Hilum of the lung

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11
Q

What is the average incubation period of MTB?

A

2 weeks to 3 months

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12
Q

When the MTB have proliferated and released its toxins, it is now called:

A

TB infection

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13
Q

PPD is initially positive at which clinical stage of MTB?

A

TB infection

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14
Q

Induration in PPD test can be detected by how many hours?

A

48 to 72 hours

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15
Q

What is the path of spread of TB infection from the hilum?

A

hilum > lymphatic spread > hematogenous spread

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16
Q

Tuberculin sensitivity develops how many weeks of months (give range) after inhalation of organism?

A

3 weeks to 3 months (most often in 4-8 weeks)

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17
Q

What is the x-ray finding in TB disease?

A

Hilar caseation

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18
Q

Which tests are typically positive in TB disease?

A

PPD skin test, Serologic test
(sputum may also be positive)

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19
Q

How many criteria qualifies for Direct Observed Treatment Short Course (DOTS) for TB?

A

3 out of 5

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20
Q

What are the criteria for Presumptive TB in <15-year-olds?

A

3 out of the 6 below:
- Coughing/ wheezing of 2 weeks
- Unexplained fever of 2 weeks, after common causes have been excluded
- Loss of weight, failure to gain weight, or loss of appetite
- Failure to respond to 2 weeks of appropriate antibiotic therapy for LRTI
- Failure to regain previous state of health 2 weeks after viral infection or exanthema
- Fatigue, reduced playfulness, or lethargy

Or any 1 of the above in a child with exposure with a known active TB case

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21
Q

What is the measurement of induration that is considered (+) PPD skin test in immunocompromised individuals?

A

more than or equal to 5mm

more than or equal to 10mm in all other children

22
Q

This includes local TB infection at the portal of entry and the regional lymph nodes that drain the area

A

Primary Complex local spread

also known as Ghon Complex

23
Q

What are the 3 characteristics of Primary Complex?

A
  1. Enlarging area of caseation
  2. Endobronchial disease
  3. TB pneumonia
24
Q

This pertains to the inflammation and caseation caused by TB on top of bronchus, compressing and/or eroding the bronchus

A

Endobronchial Tuberculosis

25
Q

Treatment for endobronchial TB disease

A

Corticosteroids

26
Q

The distinguishing feature of TB pneumonia from other pneumonia

A

Prolonged pneumonia

27
Q

This occurs when seeding of TB occurs into distant bronchial portions of the lung

A

TB pneumonia

28
Q

This is the result of failure of immune suppression of previous hematogenous spread of TB, described as smaller parts of caseation necrosis

A

Miliary tuberculosis

29
Q

This is the average incubation of miliary TB from uncontrolled primary TB infection

A

18 months

30
Q

Location of miliary TB seen on CXR

A

Hepatomegaly
Splenomegaly
Ascites/Peritonitis
Meningitis
Apical pneumonia

31
Q

This is the most serious complication of TB in children and is fatal without prompt and appropriate treatment

A

TB meningitis

32
Q

Lesions in miliary TB are often larger and more numerous in which organs?

A

Lungs, spleen, liver, and bone marrow

33
Q

What intracranial change occurs during Stage 1 of TB meningitis

A

build up of intracranial pressure

34
Q

Give 3 symptoms seen in stage 1 of TB meningitis

A
  1. headache and squinting
  2. decreased physical interest and activity
  3. fever and mild neurologic deficits
35
Q

What increases in the CSF during TB meningitis?

A

Pressure, Protein, Leukocytes, Lymphocytes

PPLL

36
Q

What decreases in the CSF during TB meningitis?

A

glucose

37
Q

How many percent is expected to have neurologic sequalae for those optimally treated during Stage 1 of TB meningitis?

A

25%

38
Q

What symptoms are manifested during Stage 2 of TB meningitis?

A

Convulsion and Decreased sensorium

39
Q

How many percent is expected to have neurologic sequalae for those optimally treated during Stage 2 of TB meningitis?

A

50-75%

40
Q

What symptoms are manifested during Stage 3 of TB meningitis?

A

Sustained convulsions and Decerebrate rigidity

41
Q

True or False: 100% neurologic sequelae is expected with Stage 3 TB meningitis

A

True

42
Q

Death from neurologic deterioration occurs during stage 3 of TB meningitis due to:

A

Aspiration pneumonia
Pressure ulcers
Cerebral herniation
Status epilepticus

43
Q

Which TB medication can cause seizures/status epilepticus?

A

Isoniazid

44
Q

Which TB medication can cause optic neuritis?

A

Ethambutol

45
Q

Which TB medication can cause red urine?

A

Rifampicin

46
Q

Which TB medication requires supplementation with vitamin B6?

A

Isoniazid

47
Q

This is the destruction of the vertebral bodies due by TB leading to gibbus deformity and kyphosis

A

Pott’s disease

48
Q

What is the confirmatory test for Skeletal TB?

A

Bone biopsy

49
Q

What is the average onset of Renal TB?

A

15 years

50
Q
A

PEDIATRICS 2 (2 decks)

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