Flashcards in TB, HIV, and Hepatitis Deck (52):
Is latent TB infectious?
How often does latent TB develop into active TB?
What is military TB?
Carried to all parts of the body
Who is at risk for TB?
Immunocompromised: DM, HIV, cancer, DM, renal failure, steroid therapy, debilitative state
Close contact: boarding schools, homeless shelters
Where is TB seen on CXR?
Signs and symptoms of TB?
Cough, fever, weight loss, lethargy, anorexia, night sweats, cough, chest pain, hemoptysis
What is the only diagnostic test for TB?
When should you test for resistance for TB, and what is defined as resistance?
Always, Drug resistant is resistant to one drug, while multi drug resistant is resistant to more than one drug
How do you check the TST?
Based solely on induration, not erythema
DD for TB?
Penumonia, pneumoitis, neoplasm, fungal infection, sarcoidosis, pulmonary fibrosis
What do you monitor for Isoniazid?
liver function and peripheral neuropathy. Can cause dark urine
What will occur with rifampin?
Side effects of pyrazinamide?
GI, myalgia, and arthralgia
What do you do for Ethambutol?
baseline eye exam, visual acuity and color vision, CBC and CNS
What's the preferred therapy for TB?
Direct observation therapy for drug resistant, intermittent therapy, and risk for non adherence
Functions of the liver?
Bile, eliminiates biliruben, metabolizes hormones and drugs, syntehsizes proteins, glucose storage, stores minerals and vitamins, converts ammonia to urea, converts fatty acids to ketones, filters the blood for metabolites and bacteria
Different causes of acute hepatitis?
Autoimmune, drugs, toxins, infections (bacteria, virsuses)
How are the different forms of viral hepatitis separated?
Only by serology
Three stages of hepatitis?
Prodromal, icteric, convalescent
Hep A transmission?
Fecal oral route
DD for hepatitis A?
Mono, cancer, obstructive jaundice, ETOH hepatitis or cirrhosis, liver injury, food poisoning, HIV acute, CMV
How do you test for Hep A
IgM and IgG
How do you transmit hep b?
blood or body fluids
How often does Hep B become chronic?
Labs for evaluation of Hep B?
HIV, GGT, genotype and viral load, serum iron, liver panel, abdominal imaging
Nomenclature for Hepatitis?
E- envolope- center
C- core- middle
S- surface, outside
Ag- antigen from virus
Ab- antibody from host
active viral repilation
How do you treat HBV?
With GI MD. Most important carcinogen after tobacco.
Treatment for HBV exposure?
HB IG within 48 hours
Who get's immunized?
MSM, all infants
How is Hep C contracted?
Primarily through infected blood
Incubation for hepatitis C?
14-180 days, with average of 45 days
Who develops symptoms and percentage that develop into chronic HCV?
20-30 develop acute symptoms, and 70-85% develop chronic HCV
Labs for HCV?
AntiHCV, HCV RNA PCR, genotyping, LFTs, ETOH, CBC, pregnancy test, TSH, A1C
Who do you screen for HCV?
Born 1945-1965, IVDU, recipient of clotting factors before 1987, HD
Shortest timeline treatment for active TB? Usually length of treatment?
6 months is shortest treatment
9 months is usual treatment
Test results for >5 mm, >10 mm, and >15 mm
>5- HIV, immunocompromised, transplant, CXR healed TB
>10- foreigners, medically underserved, IVDU, risk factors, all other medical conditions that could predispose somebody like DM, cancer, gastric surgery
>15 all other person
Who should receive hepatitis a vaccine?
Recent infection, acute infection, children, MSM, IVDU, occupational risk, clotting disorder
treatment for hepatitis A?
usually self limiting, can do IgG within two weeks
Treatment for hepatitis B?
Only do medications for chronic hepatitis B virus.
Chronicity rate for hepatitis B?
Treatment cure for HCV?
Sustained virology response for 24 weeks after then end of treatment
What should you do for people with hepatitis ABC?
Screen for alcoholism and cessation?
How long is Genotype 1 treated for HCV and Genotype 2, 3, and 4
Genotype 1 is 48 weeks
Genotype 2, 3, and 4 is 24 weeks
Most common cause of ALT and AST?
What does HBeAG and HBsAg suggest
HBeAg- active viral replication
HBsAg- persistant virus
What does IgM anti HBc suggest?
What does HBcAb suggest?