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Med Surg I > Wk 1 Tuberculosis > Flashcards

Wk 1 Tuberculosis Flashcards

1
Q

Tuberculosis etiology

A

Mycobacterium tuberculosis

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2
Q

Isoniazid is aka

A

INH

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3
Q

TB is called “multidrug-resistant tuberculosis” (MDR-TB_ if it is resistant to…

A

Isoniazid (INH) and rifampin

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4
Q

TB occurs disproportionately to what categories of people?

A

Poor, underserved, and minorities

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5
Q

People who are at higher risk for TB

A

Poor, underserved, minorities, IV drug users, people living in over-crowded conditions, poor sanitation, immunosuppressed

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6
Q

What are the three classifications of TB?

A

Primary, Latent, Reactivated

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7
Q

In primary TB, the patient inhales the bacterium which starts the __ __.

A

Inflammatory reaction

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8
Q

In primary TB, most patients mount an effective immune response that…

A

encapsulates organisms for the rest of their lives

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9
Q

In primary TB, the patient is usually __.

A

Asymptomatic

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10
Q

Is someone with primary TB contagious?

A

No

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11
Q

Persistent state of immune response to bacterium with no clinical manifestations of active TB

A

Latent TB

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12
Q

Is a patient with latent TB contagious?

A

No

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13
Q

What symptoms do patients with latent TB have?

A

None

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14
Q

A patient with latent TB will have a __ TB skin test.

A

Positive

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15
Q

Can a person with latent TB spread it to others?

A

No

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16
Q

What is the concern with a patient who has latent TB

A

They can develop active TB at some point

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17
Q

Active TB aka

A

Reactivated TB

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18
Q

What percent of patients with latent TB develop reactivated TB?

A

5-10%

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19
Q

How long does it take for a patient with latent TB to manifest symptoms of reactivated TB?

A

It can take years

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20
Q

The risk of developing reactivated TB is much higher in what groups?

A

Elderly and immunosuppressed

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21
Q

Is someone with reactivated TB contagious?

A

Yes

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22
Q

A patient with latent TB may or may not have what on a chest x ray?

A

ghon nodule

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23
Q

positive TB skin test is a clinical manifestation of __ TB

A

latent

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24
Q

positive sputum AFB is a clinical manifestation of __ TB

A

reactivated

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25
Q

Sputum AFB stands for

A

sputum acid fast bacillus

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26
Q

Point at which a patient with TB is contagious

A

Positive for AFB

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27
Q

Symptoms a patient with active TB

A

Fever, night sweats, weight loss, productive cough with purulent or bloody sputum for longer than 3 weeks

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28
Q

How long does a patient with active TB experience a productive cough?

A

For longer than 3 weeks

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29
Q

Bloody expectorate aka

A

hemoptysis

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30
Q

Two ways to evaluate TB infection

A

TB skin test and IGRA blood test

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31
Q

IGRA blood test stands for

A

Interferon gamma release assay blood test

32
Q

Both types of evaluation of TB infection evaluate which type of immunity?

A

Cell mediated

33
Q

Name of the TB skin test

A

Mantoux test

34
Q

During a TB skin test, the raised bubble under the skin is called a __.

A

bleb

35
Q

For a TB skin test, you come back in __ to __ hours to have it read

A

48-72

36
Q

What is the nurse looking for when you go back and have your TB skin test read?

A

Induration (the raised area)

37
Q

If after your TB skin test you have erythema (red area), is it positive?

A

No, only if you have induration (raised area) is it positive

38
Q

What measurement of induration is considered positive for healthy people with no known risk factors for TB?

A

15 or more millimeters

39
Q

What measurement of induration is considered positive in immigrants of less than five years from a country with high prevalence?

A

10 or more millimeters

40
Q

What measurement of induration is considered positive in IV drug users?

A

10 or more millimeters

41
Q

What measurement of induration is considered positive in residents or employees in high-risk congregate settings?

A

10 or more millimeters

42
Q

What measurement of induration is considered positive in mycobacteriology lab personnel?

A

10 or more millimeters

43
Q

What measurement of induration is considered positive in persons with clinical conditions that place them at high risk?

A

10 or more millimeters

44
Q

What measurement of induration is considered positive in children less than 4 years of age?

A

10 or more millimeters

45
Q

What measurement of induration is considered positive in children exposed to adults in high risk categories?

A

10 or more millimeters

46
Q

What measurement of induration is considered positive in HIV infected persons?

A

5 or more millimeters

47
Q

What measurement of induration is considered positive in persons with recent contact of TB infected person?

A

5 or more millimeters

48
Q

What measurement of induration is considered positive in persons with fibrotic changes on chest radiograph consistent with prior TB?

A

5 or more millimeters

49
Q

What measurement of induration is considered positive in patients with organ transplants?

A

5 or more millimeters

50
Q

What measurement of induration is considered positive in persons who are immunosuppressed?

A

5 or more millimeters

51
Q

What is the next step for a patient who has a positive TB skin test?

A

Chest x ray

52
Q

What are they looking for on a chest x ray to indicate it is positive?

A

ghon nodule

53
Q

If a patient does not have a ghon nodule on their chest x ray, but has a positive TB skin test, what does that indicate?

A

latent TB

54
Q

If a patient has a positive chest x ray, what are the next steps?

A

They will undergo further testing to confirm or rule out active TB

55
Q

Health promotion: what is the ultimate goal for TB?

A

Eradication

56
Q

If a patient is positive for active TB, what needs to happen?

A

They need to identify people they have come in contact with and they need to be tested as well

57
Q

What is essential to the treatment of active TB?

A

Strict adherence to antibiotic regimen

58
Q

What antibiotic is most commonly prescribed to treat TB?

A

Isoniazid (INH)

59
Q

Patients who are on antibiotics for TB will take them for how long?

A

Months, maybe even years

60
Q

What may be ordered prn for a patient with TB?

A

Direct observation therapy

61
Q

Why would a patient be ordered direct observation therapy?

A

They have been noncompliant with their drug regimen

62
Q

What happens during direct observation therapy?

A

The patient is put in a situation where they go somewhere and we supervise them taking the pills

63
Q

What is the purpose of direct observation therapy?

A

Increase adherence and decrease multi drug resistant TB

64
Q

Notable side effects of isoniazid

A

hepatotoxicity and peripheral neuropathy

65
Q

What is peripheral neuropathy?

A

A result of damage to the nerves located on the outside of the brain and spinal cord.

66
Q

What is hepatotoxicity?

A

Damage to the liver, or toxic liver disease.

67
Q

What is another drug that causes hepatotoxicity?

A

acetaminophen

68
Q

Notable side effects of rifampin (Rifadin)

A

red/orange discoloration of excretions

69
Q

Notable side effects of ethambutol (Myambutol)

A

decreased visual acuity, inability to differentiate between red and green

70
Q

What type of precautions are someone with TB on?

A

Airborne

71
Q

A patient with active TB will be in what type of room?

A

Private room with negative pressure ventilation

72
Q

What type of mask will the nurse wear when treating a patient with TB?

A

N-95 HEPA mask

73
Q

What does HEPA mask stand for?

A

high-efficiency particulate air mask

74
Q

How often are healthcare workers tested for TB?

A

Annually

75
Q

If you are at high risk for contact for TB, you may be placed on…

A

preventative drug therapy

76
Q

Prevention of transmission of patients at home includes..

A

Preventative drug therapy to high risk contacts, cover mouth/nose, wear mask in crowds, sputum AFB q 2 weeks

77
Q

How many negative sputum AFB cultures for indicate a patient is no longer infectious?

A

3

Med Surg I (41 decks)

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