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TB Flashcards

1
Q

what are the three causative agent of pulmonary tb?

A

mycobacterium tuberculae

mycobacterium africanum

mycobacterium bovis

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2
Q

what do the three causative agent do in the lungs?

A

they attack the lung tissue

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3
Q

what lung tissue do the causative agents attack specifically?

A

lung parenchyma

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4
Q

what organs do the causative agent attack other than the lungs?

A

heart, liver, throat

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5
Q

mode of transmission of tb

A

airborne
droplet
milk as a vehicle

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6
Q

how milk posturized?

A

pasteurization of milk, designed to destroy the pathogen COXIELLA BURNETTI, is accomplished by a time/temp. integrated process.

63 degrees Celsius for 30 minutes
71.7 or 72 for 15 minutes

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7
Q

incubation period for TB

A

2-10 weeks

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8
Q

enumerate the cardinal signs of TB

A

cough
night sweat
weight loss
anorexia
loss of appetite
hemoptysis
low grade fever

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9
Q

what. are the two direct sputum smear microscopy of tb?

A

conventional strategy (spot)

spot-spot

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10
Q

in conventional spot, when do the patient return?

A

early morning the next day

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11
Q

how many specimen in spot-spot?

A

3

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12
Q

what are the 3 specimen in spot-spot?

A

one spot
2nd spot
3rd spot

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13
Q

one spot

A

right there and then

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14
Q

2nd spot

A

after 1 hour

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15
Q

3rd spot

A

the next day early in the morning

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16
Q

nursing consideration for direct spot smear microscopy

A

no mouthwash, plain water only

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17
Q

what are the 3 diagnostic test for tb

A

direct spit smear microscopy
sputum analysis
tuberculin skin test or mantoux test

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18
Q

in sputum analysis, what indicates 2 positive specimen?

A

positive tb

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19
Q

in sputum analysis, what indicates 1 positve and 1 negative specimen?

A

needs chest xray

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20
Q

what procedure determines the extent of the lesion?

A

chest xray

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21
Q

other term for tuberculin skin test

A

purified protein derivative or mantoux test

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22
Q

what is tuberculin test?

A

to test susceptibility exposure and immunity of tuberculosis

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23
Q

how to determine if it is positive of tuberculin test?

A

wheal formation or induration

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24
Q

size of wheal formation?

A

10mm

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25
route of tuberculin skin test?
intradermal
26
how many ml do they inject in tuberculin skin test? what site?
0.1 ppd injected to left forearm
27
how many days do they wait for the result of tuberculin test?
2-3 days or 48-72 hours
28
classification based on history of previous TB treatment
new relapse treatment after failure treatment after lost of follow up (talf) previously treatment outcome unknown (ptou) other
29
discuss NEW
- newly diagnosed patient - positive sputum smear - someboday who have taken anti-TB dugs for less than a month
30
discuss RELAPSE
might have been cured but diagnosed to have tB again
31
discuss treatment after failure
finished treatment regimen but Still have TB ; never cured
32
discuss TALF
started tx however never follow-up for 2 months
33
discuss PTOU
claimed that pt has undergone TB tx however there’s ' no treatment record or document no evidence
34
discuss OTHER
pt who does not fit to any category
35
what are the recommended category of treatment regimen?
c1,c2,c3,c4
36
C1
+ sputum mear -newly diagnosed pt -extensive Parenchymal lesion - seriously ill
37
c2
- relapse -treatment after failure -TALF, PTOU - other
38
C3
- newly diagnosed - (+)sputum smear - slightly / minimal lesion
39
C4
-chronic PTB -still w/ TB after supervised treatment -chronic PTB - Helpless/ hopeless
40
drugs for C1
2 months HRZE 4 months HR
41
drugs for C2
2 months HRZES 5 months HRE
42
drugs for C3
2 months HRZ 4 months HR
43
drugs for C4
none
44
intensive phase
2 months
45
maintenance phase
4 months except C2
46
maintenance phase of C2
5 months
47
First line drugs of TB
Rifampicin (H) Isoniazid (Z) pyrazinamide Ethambutol Streptomycin
48
SE of rifampicin
red orange urine, tears, sweats
49
SE of isoniazid
peripheral neuritis/neuropathy (tingling and numbness of the extremities)
50
SE of pyrazinamide
hyperurecemia nephrotoxicity hepatotoxicity
51
management for hyperurecemia
no purine rich food such as organ meats
52
what labs do nurses monitor for pt taking pyrazinamide with a side effect of nephrotoxicity?
BUN and Creatinine
53
normal BUN and creatinine?
BUN - 10-20mg/dl Creatinine - 0.4-1.2
54
what labs do nurses monitor for pt taking pyrazinamide with a side effect of hepatotoxicity?
AST and ALT
55
SE of ethambutol
optic neuritis damage eyes loss of vision (transient or temporary) difficulty discriminating yellowish-green
56
what specific part of the eyes do ethambutol affects?
optic disc
57
nursing consideration for loss of vision
snellen chart
58
nursing consideration for difficulty discriminating yellow-green color
Ishihara diagram
59
what cranial nerve do streptomycin affects?
8th cranial nerve ( acoustic nerve)
60
SE of streptomycin
tinitus vertigo loss of balance ototoxicity
61
second line of drugs of tb
amikacin kanamycin capreomycin
62
classification of second line drugs
amino glycosides
63
route of second line drugs
IV or IM
64
SE of second line drugs
ototoxicity hepatotoxicity nephrotoxicity
65
Other second line drugs
Ciprofloxacin moxifloxacin levofloxacin
66
classification of other second line drugs
fluoroquinolones
67
route of other second line drugs
per orem
68
SE of other second line drugs
headache N/V
69
No LIVE VAXX for?
immunocompromised patients
70
Prevention/ vaccine for TB Content: Given when: Dosage: # if doses: route: old sched: new sched: SE:
Content: LIVE ATTENUATED BACTERIA Given when: AT BIRTH Dosage: 0.05 ML # if doses: 1 route: INTRADERMAL old sched: AT BIRTH new sched: AT BIRTH SE: PERMANENT SCAR, LOCAL SORENESS, FEVER
71
nursing consideration for local soreness
apply warm compress do not massage the scar
72
nursing considerations for fever
give antipyretics continue breastfeeding
73
Absolute considerations for LIVE ATTENUATED BACTERIA
cough, hiv, aids, immunocompromised
74
contraindications for any vaxx
chemotherapy glucocorticoids therapy ( sone) for fever more than 38.5
75
vaccine reconstitution
BCG
76
BCG: Diluent: Syringe: Discharge:
Diluent: sterile water: 2-3 ml Syringe: 5cc Discharge: after 4 hrs

CD (11 decks)

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