TB Flashcards
(9 cards)
Clinical manifestations & Treatment of T.B in HIV Patient
- if Patient is already on HIV TTT: Start TB treatment simultaneously
- if Patient recently diagnosed as TB & HIV : Begin TTT of TB first for 2-3 weeks then HIV Treatment
1-Initial phase for 2 months - INH
- Rifampicin
- Ethambutol
- Pyrazinamide
2-Continous phase for 6 Months & upto 1 year in CNS T.B - INH
- Rifampicin
Anti tuberculous drugs
I..Respالتحشيشة
1-INH..(5mg/kg)
*Intra$Extracellular
*SE:
I:Lupus like symptoms
N:Neural :decrease vit B6
H: Hepatotoxicity
2-Rifampicin (10mg/kg)
*Intra$Extracellular
*SE:
-Drug interaction with:OCP, cortisone,cytotoxic drugs.
-Hepatotoxic
3-Ethambutol (15mg/kg)
*Intra$Extracellular
*Bacteriostatic
*SE:Eye(optic neuritis,color vision blindness red$green)
4-Pyrazinamide (25mg/kg)
*Intracellular
*SE:
-Hepatotoxicity
-Hyperurecemia
5-Streptomycine(20mg/kg)
*Extravascular
*SE:
Oto,nephro, neurotoxicity
Species of mycobacterium and their related illness
- Mycobacterium tuberculosis complex
Species: Mycobacterium tuberculosis, M. bovis, M. africanum, M. microti, M. canettii
Disease: Tuberculosis (TB)
Primarily affects lungs (pulmonary TB), but can affect any organ (extrapulmonary TB)
2. Mycobacterium leprae
Disease: Leprosy (Hansen’s disease)
3. Mycobacterium avium complex (MAC)
Species: M. avium, M. intracellulare
Disease:
Disseminated disease in immunocompromised (esp. HIV/AIDS)
Pulmonary disease in patients with chronic lung conditions
4. Mycobacterium kansasii
Disease:
Pulmonary disease resembling TB
5. Mycobacterium marinum
Cause:Skin infections “Fish tank granuloma”
6. Mycobacterium ulcerans
Disease: Buruli ulcer
Chronic ulcerative skin disease, mainly in tropical regions
7. Mycobacterium fortuitum, M. chelonae, M. abscessus (Rapidly growing mycobacteria)
Diseases:
Skin and soft tissue infections
Post-surgical wound infections
Catheter-related infections
Pulmonary disease (especially M. abscessus)
The followings are important in the diagnosis of tuberculosis EXCEPT?
A. Culture.
B. Microscopy.
C. Serology.
D. Polymerase chain reaction
C
مكنش حد غلب يابا
A 63-year-old man lived in a hostel for the homeless and sold magazines outside a railway station. He had been feeling weak, had lost weight, and often had a fever at night. One month ago, he started coughing up blood and feeling breathless, which had really worried him. Next day he went to the practice and was seen by the physician on duty, who found that the patient had a low-grade fever and detected bronchial breathing when he listened to his chest. The doctor sent him for a chest X-ray and asked him to return for the results. When the X-ray result came back, it showed that he had apical shadowing and large cavitation.
a) What is the most probable diagnosis and the causative agent?
TB
ليه؟
Weight loss +night fever + apical shadow with cavitation
b) How is this disease diagnosed and what is the differential diagnosis?
Diagnosis
1-Sputum culture with acid fast bacilli.
2-PCR (Gene expert)
3-Tuberclin test.
4-Tb gold quantifrron
DD
1-Bronchogenic carcinoma
2-Fungal infection (Histoplasma, aspergillus)
3-Lung abscess.
4-Sarcoidosis الاخ
MDR TB
Definition:
TB doesn’t respond to at least 2 powerful common anti-TB drugs.
Causes of MDR TB
باختصار
*الدوا مش موجود
*الدواء موجود والعيان مبياخدوش
*الدوا موجود والجرعات فيها غلط
* العيان hiv
*البكتريا حصل لها mutation
1-Genetic mutations: - By random chromosomal mutation
2-Inadequate drug supply or poor quality
* Not available
* Poor storage
* Poor quality.
3-Inadequate drug intake
* Drug-drug interaction
* non compliance of pt
* Discontinuation of Tx
* Mal-absorption
4-Inadequate drug regimen:
* Absence of guidelines
* non compliance to guidelines
* Loss of supervision of treatment
5-AIDS & HIV
