ILA 6 Flashcards Preview

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Flashcards in ILA 6 Deck (22)
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1
Q

What is erythema marginatum seen in?

A

Rheumatic fever

2
Q

Give some RFs for TB

A
  • Urban area
  • ethnic minorities (+ born in TB prevalent countries)
  • Living in same house as someone w/ TB
  • Cramped lving conditions
  • Homelessness, alcoholic, drug abuse
  • Immunocompromised
  • Malnourishment
  • Male
  • occupation: hospitals, care homes…
3
Q

Give some causes of erythema nodosum

A
Sarcoidosis
TB
IBD
EBV (on placement)
Non-hodgkins lymphoma
4
Q

What are some SEs of rifampicin?

A

Hepatitis + orange urine/tears

5
Q

What are some SEs of isoniazid?

A

PERIPHERAL NEUROPATHY + heptitis

6
Q

What are some SEs of pyrazinamide?

A

hepatitis + Gout (hyperuricaemia)

7
Q

What are some SEs ethambutol?

A

Optic neuritis + red-green colour blindness

8
Q

Give an example of a 2nd line drug Tx for TB

A

Macrolides - e.g. azithromycin or clarithromycin

9
Q

How would you diagnose TB?

A

CXR
Sputum sample / bronchial lavage / other sites (e.g. lymph node biopsy) –> culture/staining + rifampicin resistance (ziel-neelson stain for acid fast bacilli + lowenstein jenson) - can now do PCR

10
Q

What are the stains/culturing techniques for tb? Which is faster?

A

Ziel-Nelson stain for acid-fast bacilli (faster)

Lowenstein Jenson slope

11
Q

How many sputum samples are needed to Dx TB?

A

3

12
Q

What must you test a person for who has TB?

A

HIV, HepB/C

13
Q

What is the primary infection of TB called?

A

Gohn focus

14
Q

What is a primary focus?

A

Gohn focus + hillier lymphadenopathy (infected caseating lymph nodes)

15
Q

How do you contact trace people for TB?

A

Mantoux test (tuberculin skin test) –> If +ve: IGRA (IFN gamma release assay)

16
Q

If a mantoux test comes back +ve in contact tracing, what would you do? Why?

A

IFN-gamma testing - as may be immune/BCG

17
Q

If IFN-gamma testing comes back +ve, what should you do?

A

Give the contact isoniazid + rifampicin

18
Q

If the Mantoux test comes back -ve what should you do to the contact?

A

BCG vaccine

19
Q

Who should be vaccinated w/ a BCG?

A

All infants in high prev areas (>40/100000)

Infants with parents/grandparents from high prev areas

Unvaccinated contacts of someone with pulmonary TB (with a -ve mantoux test)

Health care workers, vet workers, prison staff

20
Q

What is the appearance of miliary TB on CXR?

A

Millet seed appearance

21
Q

Describe some challenges faced by immigrants in the healthcare system

A
PTSD (refugees)
Not Understanding the healer system
Different screening programme
Different vaccination programme
Tropical disease (E.g. Milaria)
22
Q

Describe some challenges of using an interpreter

A
Longer appointment
Cost of interpreter
decreased raport with dr (less likely to disclose important information
different culture
confidentiality issues