Day 5- Tuberculosis Flashcards
How is tuberculosis transmitted and can you get it from someone who has latent TB?
What organs get affected by tuberculosis?
What are your risk factors for TB?
Airborne infection(coughing, sneezing, speaking or singing). NO!
Regional lymph nodes, apex of the lungs, larynx, kidneys, spine, brain, bones.
Close contact to an active contagious pulmonary disease(household, incarceration, nursing homes, school, dialysis center).
What other medical conditions give you a risk for TB?
What drugs can cause tuberculosis?
What are symptoms of active TB?
HIV is strongest risk factor for development of TB, drug induced immunosuppresion.
When you block TNF-alpha, TB disease should be considered in the differential diagnosis for ALL immunocompromised patients with unexplained febrile illness.
Fever, chills, night sweats, unexplained weight loss, productive cough, pain at lymph nodes, etc. Coughing blood, etc.
What is the treatment of latent TB with Isoniazid?
What is the treatment of latent TB with Rifampin?
What are your counseling points for latent TB?
300 mg once daily for 9 months. Watch for elevated LFT’s nephropathy, optic neuritis, arthralgias, etc. Can use Vitamin B6 for peripheral neuropathy.
Patients who can not tolerate INH or exposted to INH resistant TB. 600 mg once daily for 4 months.
Avoid birth control, Do not wear contacts, should be taken on an empty stomach.
What is the Rifapentine treatment?
What is active TB’s treatment regimen?
What treatment regimen do you give if they have HIV?
Dosing is weight based once weekly for 12 weeks. Used in combination with Isoniazid.
4 drug combination for 8 weeks followed by 18 weeks of 2 drug combination.
Give Rifabutin and not Rifampin however renal dosing IS required–> decrease dose by 50% if CrCl <30.
Does ethambutal and pyrazinamide require renal dosing?
What is the only thing that can confirm diagnosis of TB?
What pathogens usually cause AOM and which one is the MOST common cause of recurrent and persistent AOM?
YES
Culture. All other testing is screening.
S.pnuemoniae, H.influenzae, Moraxella catarrhalis. Penicillin-resistant S. pnuemoniae.
When do you begin antibiotics immediately in severe AOM?
When do you being antibiotics in non severe bilateral AOM(6-23 months) and how does that differ vs unilateral?
What do you do if someone is older than 24 months?
Severe AOM> 6 months, moderate or severe otalgia or otalgia >48 hours or temp >102.2. Begin them IMMEDIATELY.
Begin immediately. Mild otalgia for <48 hours and temp <102.2. Antibiotics or observation.
Observation. Can do antibiotics but do observation first.
When are antibiotics most effective in AOM?
How do you treat AOM and dosing with pain meds?
What is preferred antibiotic for AOM?
Children younger than 2 with bilateral acute otitis media, <6 months old, acute otitis media with otorrhea.
Acetaminophen(160mg/5mL) 15 mg/kg every 6 hours, Ibuprofen(100mg/5mL) 10 mg/kg every 6 hours.
Amoxicillin. 80-90 mg/kg per day in 2 doses.
What is the alternative antibiotic for AOM but have penicillin allergy?
What is your 2nd if amoxicillin fails?
What is AOM standard duration of treatment?
Azithromycin.
Augmentin.
10 days.
What is the preferred antibiotic for strep throat and what do you use for penicillin allergy?
How long does viral rhinosinusitis last?
What is 1st line treatment for ABRS?
Penicillin. Azithromycin.
7-10 days.
Augmentin, can use levofloxacin or moxcfloxacin for PCN allergy.
When ABRS(more than 10 days) is suspected should you recommend decongestants and antihistamines?
NO!!!
