Section 5

Question 1

Tuberculosis

Answer 1

disease syndrome caused by mycobacterium tuberculosis; 2nd most common infectious COD; primary infection site is always the lungs

Question 2

TB disease courses

Answer 2

1. immediate clearance
2. primary disease
3. latent infection
4. reactivation

Question 3

TB spread

Answer 3

inhale respiratory droplets that settle in the alveolar spaces in mid/lower lungs. TB infiltrates macrophages & causes local inflammation & necrosis. TB can spread to lymph nodes and into the blood stream; imitates other diseases due to symptoms

Question 4

TB is AKA

Answer 4

the great imitator

Question 5

primary infection v disseminated

Answer 5

primary location is the lungs and disseminated is being present in any second site

Question 6

symptoms of clinical disease appear when

Answer 6

you have TB spread and lympahdenopathy

Question 7

TB clinical symptoms

Answer 7

nonspecific; fever, night sweats, weight loss, anorexia, weakness (similar to cancer); 90% cough that is initially nonproductive but is accompanied by purulent sputum +/- hemoptysis

Question 8

Why does hemoptysis occur?

Answer 8

due to vessel erosion by TB spread

Question 9

TB diagnosis

Answer 9

Requires organized lab network and clinical suspicion

• microscopy
• Xpert technology
• Xray

Question 10

Gold standard in TB dx

Answer 10

culture the sputum sample; takes 6 weeks to grow rough or smooth buff colored TB colonies

Question 11

AFB sputum microscopy

Answer 11

acid fast bacilli stain performed in hospital same day; looking for presence of organism to determine if patient is actively infections; would not see in latent infection

Question 12

Xpert MTB/RIF

Answer 12

rapid diagnosis technology

Question 13

False + PPD

Answer 13

due to some vaccines; take XR to determine if there are infiltrates and cavities with air fluid levels; does not confirm TB

Question 14

When you suspect a patient has TB

Answer 14

place on isolation and respiratory precautions until ruled out 3 sputum stains and 2 Xpert PCR

Question 15

TB value examples

Answer 15

MD coordinates & leads team
RN carries out orders
RT coordinates with MD & RN

Question 16

TB roles examples

Answer 16

MD orders respiratory isolation
RN ensure these orders
RT obtains sufficient samples

Question 17

TB communication & teamwork examples

Answer 17

microlab results in timely manner
MD response appropriately and orders treatment or suspension of precautions
Public & private health sector

Question 18

Public sector

Answer 18

plan, coordinate & eval TB control & prevention efforts

Question 19

Private sector

Answer 19

educate & support practitioners & hospitals

Question 20

CDC TB control plan example

Answer 20

assign roles 
define communication pathways
assign resources
provide guidance to labs
assist local authorities
provide info to patients