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TB Flashcards

1
Q

What bacterium causes TB

A

Mycobacterium tuberculosis

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2
Q

Full Latin name for TB

A

Mycobacterium tuberculosis

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3
Q

What group in the US is more likely to have TB

A

Foreign-born individuals

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4
Q

What are the six risk factors of TB

A

Malnutrition
Immunosuppressed
Overcrowded living conditions
Institutional living
HIV
Alcohol abuse

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5
Q

How do most people present with TB

A

Asymptomatic
Maybe slight fever

Many don’t seek treatment

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6
Q

Describe mycobacterium tuberculosis

A

Long rod shape
Slow growing
Waxy capsule
Resistant to gram stain

Need fast acid

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7
Q

What are non aerosol ways to contract TB

A

Direct inoculation through skin during post-mortem

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8
Q

Other than by mouth how else can you inhale TB aerosols

A

Improperly handling infected fluids (urine, feces)

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9
Q

What are classic presentations of TB (vitals and what you see)

A

Chronic (wracking) cough
Hemolysis
Wasted appearance
Tachycardia
Tachypnea

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10
Q

Classic symptoms of TB

A

Fever/chills
Soaking night sweats
Fatigue
Loss of appetite

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11
Q

What about a patients history can indicate TB

A

Recent weight loss

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12
Q

What might be heard during auscultation during TB

A

Crackles
Pleural friction rub

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13
Q

What is heard during percussion of a TB patient

A

Dullness over apices

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14
Q

What is seen on a CXR of a TB patient

A

Lymphadenopathy (first)
Primary TB
Cavitation
Post primary TB

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15
Q

Where in a CXR is pathology of TB focused

A

Middle and Apices (oxygen rich)

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16
Q

Who is a the highest risk of death associated with TB

A

The old and very young

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17
Q

Define Tuberculosis

A

Contagious, chronic infection from mycobacterium tuberculosis

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18
Q

By how much did the incidence of TB increase from 2020-2023

A

4.6%

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19
Q

Risk factors for TB (6)

A

Malnutrition
Institutional living
Living in crowded conditions
Immunosuppression
HIV
Alcohol abuse

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20
Q

Who in the US is more likely to have TB

A

Foreign-born individuals

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21
Q

Describe the bacteria that causes TB

A

Long rod
Slow growing
Waxy capsule
Resistant to gram stain

Acid fast!!

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22
Q

How is TB spread

A

Aerosolize droplets

Not touching objects (fomites)

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23
Q

Other than aerosolized droplets how can you contract TB

A

Direct inoculation through skin during post-mortem

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24
Q

Other than by mouth how can you come in contact with TB aerosols

A

Improperly handling infected fluids and inhaling them (urine, feces)

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25
How do patients with TB usually present
Usually asymptomatic Maybe slight fever (Don’t get assessed)
26
Classic TB presentation (vitals and look)
Chronic (wracking) cough Hemolysis Wasted appearance Tachycardia Tachypneic
27
Classic symptoms of TB
Fevers, chills Soaking night sweats Fatigue Loss of appetite
28
What history of presentation might a TB patient have
Recent weight loss
29
What will you hear during auscultation of a TB patient
Crackles, pleural friction rub
30
What is heard during percussion of a TB patient
Dull in apices
31
What are the three groups of TB
Primary TB Post primary TB Disseminated TB
32
What is the process of development of primary TB
Follows initial exposure What inhaled bacilli implant in alveoli Over 3-4 weeks bacteria multiply
33
How do the lungs react to primary TB
Inflammation (Similar to acute PNA)
34
What is the process of development of primary TB
Neutrophils and MACs attempt to engulf bacilli but can’t kill them Pulmonary cap dilate and interstitium fills w/ fluid Alveolar edema Patient has a positive ppd test
35
What does the lungs do what they can’t kill TB
Tissue will create a granuloma or tubercle to encase it
36
How does the TB tubercle core look
Cheese-like necrosis mixed with TB bacilli surrounded by WBCs
37
What is the initial lesion from TB called on a CXR
Ghon nodule or Ghon focus
38
39
What TB classification does reactivation TB fall under
Post primary TB
40
How long does it take for a tubercle in TB to form
2-10 weeks
41
What are the two ways TB bacilli can be controlled
The immune system Antibiotics
42
What replaces the tubercles
Tissue fibrosis and calcification of the lung parenchyma
43
Once calcified the Ghon complex is termed…
The Ranke complex
44
What is the remaining scared and retracted TB lung tissue at risk of
Distorting the bronchi to the point of Bronchiectasis
45
What causes reactivation of TB
Patient immune system AIDS/HIV Malnutrition Alcoholism Aging Caseous granulomas resurface
46
What is a patient at risk of with unchecked TB
Becoming highly contagious Tubercle rupture
47
What happens if a tubercle is ruptured
Ruptures into the pleura space allowing air and infected material to flow into the space or the tracheobronchial tree
48
What is disseminated TB
What it spreads to throughout the body
49
How does TB bacilli spread
Escape through cavitation and rides through the bloodstream or lymphatics to places with high O2
50
What is the Ghon Complex
A sign of TB seen on a CXR caused by spread from nodules to the lymph nodes of the hilar
51
What test are done to diagnose TB
Mantoux Tuberculin skin test Acid fast stain of sputum Culture of sputum CXR QuantiFERON TB Gold test
52
Describe the Mantoux test
Injected with a purified protein derivative of TB bacillus Check in 48-72 hrs
53
Does a positive Mantoux mean active TB
Not necessarily. It means recent or past infection
54
How long does it take to receive a TB sputum culture result
6 weeks
55
Explain a AFB test
Must test negative three times 8-12hrs apart for a rule out First morning sputum is best
56
What does the Ziehl-Neelsen stain look like
red bacilli
57
What does the fluorescent AFB look like
Yellow-green bacilli with dark background
58
How many drugs and how long does a TB treatment last
2-4 med and 6-9 months
59
What antibiotics are used for TB
Rifampin Isoniazid
60
What do you do if TB bacilli become resistant to one or more of the antibiotics
Add at least three antibiotics
61
In reference to TB What is (DOT) and who gets it
Direct observation therapy For patients who are at risk of not complying with medication taking
62
What QuantiFeron-TB Gold Test
Blood is mixed with synthetic antigen and control and incubated for 16-24 hours If infected, WBCs will release IFN-gamma Recommended w/AFB and CXR

Disease II (14 decks)

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