Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

2nd Semester Final > Tuberculosis Lecture Powerpoint > Flashcards

Tuberculosis Lecture Powerpoint Flashcards

1
Q

Tb is a ____ disease due to ______

A

multi-organ, disseminating miliary Tb which spreads hematologically to diff tissues throughout the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Gold standard for diagnosis of Tb***

A

Quantiferon gold, highly specific and sensitive for Tb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hepatotoxicity in patients receiving pharmacologic treatment for Tb

A
  • routine LFT before beginning 4 drug regimen
  • if normal no more tests unless symptoms develop
  • if abnormal, monthly LFT’s required
  • If these results are less than 2x the upper limit with no side effects repeat in one month
  • if they are greater than 2x the upper limit, consult physician
  • if they are 3x the upper limit at any time, consider stopping therapy
  • drug induced hepatotoxicity is defined as AST/ALT

-Isoniazid is the most hepatotoxic of these drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Historically Tb was often labeled as….

A

….consumption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

___% of the population is infected with Tb

A

25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Tuberculosis risk factors (4)

A
  • Those in close contact with Tb patients thru facilities or family
  • Healthcare workers
  • Individuals born in countries with high prevalence of Tb
  • Medically underserved populations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Populations at risk for progressing to active Tb infection once exposed (4)

A
  • People with recent Tb infection
  • Immunosuppressed patients (HIV, cancer, DM, long term corticosteroids)
  • IV drug or substance users
  • Children
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Tb causative agent and infectious process

A

Mycobacterium tuberculosis (acid fast bacilli that transmits thru inhalation of aerosols to any high area of o2 flow in the body - lungs most popularly but any system)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Name the 3 stages of Tb infection

A
  • Primary
  • Latent (asymptomatic, CXR is normal or shows ghon complex, 90% never develop active infection unless reactivated due to immunosuppression)
  • Reactivated (in immunocompromised will often present in different organ systems)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Ghon complex

Ranke complex

A

Fibrotic calcified lesion from local inflammatory response of the lungs from inhaled Tb bacteria indicating latent Tb infection seen on CXR

Further calcified lesion from Tb bacteria exposure that is an evolution of the ghon complex and indicates a latent Tb infection seen on CXR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Immunocompetent hosts have a __% lifetime risk of reactivation of Tb infection, but HIV patients its ___% per year

A

10, 10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Granuloma formation mech of action

A
  • Macrophages, lymphocytes and antigenic material forms caseous necrosis lesions
  • Calcification of these areas occurs creating ghon complexes
  • Cavitations (holes) form most often seen at the apices of the lungs (that’s why we auscultate and palpate em!)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Scofula

A

Lymph node infection by Tb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pott’s disease

A

Skeletal infection by Tb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Sinus tracts

A

Hole in skin manifestation often with purulent material from deep granuloma from Tb in deep tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Active Tb symptoms (4)

A
  • Intermittent fevers
  • Night sweats
  • Wasting
  • Chronic cough
17
Q

Rasmussen’s syndrome

A

Massive hemoptysis when a cavity from progressed Tb infection erodes into the pulmonary artery

18
Q

Tb lab studies (4)

A
  • PPD
  • Acid fast smear/culture
  • CXR
  • Quantiferon gold
19
Q

PPD screening*** and what causes false negatives?

A
  • Screens for exposure not active disease
  • Read 48-72 hrs after otherwise invalid
  • measure diameter of induration, not redness and record in mm with 0 mm representing negative
  • Test only at risk populations
  • 2 step testing required, might see first test neg and 2nd test positive so that’s why we do it (booster phenomenon)
  • **false negatives are due to anergy, steroids, or HIV
20
Q

CXR signs of primary, latent, or reactivated Tb infection

A

Primary: calcified peripheral nodule with or without calcified hilar lymph nodes
Latent: rarely shows findings may reveal fibrotic area
Reactivated: granuloma (multiple), cavitation (usually apical), hilar lymphadenopathy, pleural effusions

21
Q

***Having a BCG vaccination will lead to what result on PPD and what result on Quantiferon gold test?

A

Will result in false pos on PPD, does not affect accuracy of quantiferon gold test

22
Q

CDC guidelines for positive PPD skin tests*** (Induration of 5, 10, or 15 mm)

A

Induration of 5 or more mm is positive in…
-HIV patients
-Recent contact of Tb disease
-person with fibrotic changes on chest radiograph
-patients with organ transplants
-patients taking immunosuppressants for other reasons
Induration of 10 or more mm is positive in…
-Recent immigrants
-IV drug users
-High risk location residents
-Mycobacteriology lab personnel
-Children
Induration of 15 more more mm is positive in…
-Any person including those with no known risk factors for Tb

23
Q

Tb reporting

A

Must report to PA department of health within 5 days

24
Q

Steps following active Tb diagnosis (5)

A
  • Get baseline LFT, CBC, and platelets
  • Isolate patient if coughing until at least 2 weeks after treatment or 3 sequential sputum specimens for AFB return negative
  • 3 drug initial therapy minimum
  • If fail add 2-3 drugs to regimen (not just one)
  • Involve local health department
25
Q

Active Tb treatment options (5) and how long are they taken?

A
  • Isoniazid
  • Rifampin
  • Ethambutol
  • Pyrazinamide
  • Modifications made in drug resistance, pregnant patients, or children

-Drugs taken for 6-9 months

26
Q

***Isoniazid patients can develop peripheral neuropathy as a side effect. What is given as supplement to prevent this?

A

-Vit B6 20-50mg/day

27
Q

Drug found beneficial to treatment of multi drug resistant TB

A

Bedaquiline fumarate

28
Q

Latent Tb treatment options (3) and ADR of each

A
  • Isoniazid (can cause itching or rash, increased LFT’s)
  • Rifampin (can stain body fluids)
  • Rifapentine (can stain body fluids)
29
Q

Children <5 year old post Tb exposure protocol

A

Need treatment ASAP despite PPD results, retest in 3 months

2nd Semester Final (207 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions