TB

Question 1

what is the MCC of young person pneumonia that lives in close quarters?

Answer 1

mycoplasma

Question 2

what does a fatty embolus cause in the lungs?

Answer 2

diffuse pulmonary infiltrates

Question 3

what can prevent pneumonia post op?

Answer 3

incentive spirometry

Question 4

what is MCC of pneumonia in HIV pts?

Answer 4

PCP

Question 5

which obstructive lung dz has predominantly neutrophil driven inflammation?

Answer 5

COPD

Question 6

80% of chronic cough is caused by what three etiologies

Answer 6

GERD

Question 7

what is the MCC of CAP?

Answer 7

strep pneumo

Question 8

what two blood tests are helpful in treating asthma?

Answer 8

RAST panal

IgE

Question 9

where are tb bugs kept in remission?

Answer 9

alveolar macrophages

Question 10

when will TB become an active infection?

Answer 10

bug escapes from alveolar macrophage

Question 11

when does TB dissemination occur?

Answer 11

before an active immune response

Question 12

where are common areas that TB can affect?

Answer 12

brain, larynx, lymph node, lung, spine, bone, kidney

Question 13

what helps evaluate likelihood of infection of TB?

Answer 13

infectiousness of person with TB
environmental factors that increase infectivity
proximity, frequency, duration of exposure

Question 14

how long after infection will LTBI be detected on TST or interferon gamma assay (IGRA)?

Answer 14

2-8 weeks

Question 15

do ppl with LTBI spread infection?

Answer 15

no

Question 16

in how many ppl with LTBI become active TB?

Answer 16

10%

half occur within 2 years of initial infection

Question 17

what confirms TB infection?

Answer 17

positive TB culture (most often obtained by bronchoscopy)

Question 18

what percentage of HIV ppl will get active TB after being exposed to it?

Answer 18

50%

Question 19

who else is at risk for getting TB?

Answer 19

silicosis (interstitial lung dz)
DM
steroid use
gastrectomy
children <5yrs

Question 20

what are clinical features of TB

Answer 20

fever, chills, nightsweats, anorexia, wt loss, fatigue, chronic productive cough, CP, +/- hemoptysis, blood-streaking MC (frank blood is rare)

Question 21

what are extrapulmonary features of TB if it has gone to other organ systems?

Answer 21

blood in urine
h/a, confusion
back pain
hoarseness

Question 22

what is PE of TB lungs?

Answer 22

post tussive apical rales, but often is normal

Question 23

in which pt would a 5mm PPD be a positive?

Answer 23

HIV
recent TB contacts
Fibrotic changes on CXR (indicating prior TB)
PING

Question 24

in which pt would a 10 mm PPD be a positive?

Answer 24

recent immigration
injection drug user
medical workers/mycobateria lab workers
children <5yo

Question 25

in which pt would a 15 mm PPD be a positive?

Answer 25

no known TB risk (general population)

Question 26

what are the 3 most common non TB infections?

Answer 26

M avium, M chelonae, M absessus
difficult to treat
3-5 drug regimen for 18 months