TB/Liver Disease Flashcards
(46 cards)
TB - —- most common cause of infectious death worldwide —- is 1
2nd
AIDS is 1.
WHO estimates — of world population infected with latent TB
1/3
BCG vaccine is for
TB - only in high risk people.
Mycobacterium tuberculosis spread by
inhalation of infected droplets
Mycobacterium tuberculosis
Deposition in lungs results in:
- Immediate clearance of organism
- Primary disease
- Latent infection
- Reactivation disease
TB Primary disease - symptoms - only occurs in —- of pts who inhale TB (first couple days/weeks this occurs). This is like a lot of infectious diseases - lung symptoms don’t come around until later (like a flu). 90% asymptomatic.
5-10%
Latent infection - TB
—— ingest, body walls off in granulomas in lungs. Eventually, bacteria replicate and granuloma keeps it back.
Alveolar macrophages
TB
Clinical manifestations
Cough >2-3 weeks’ duration Lymphadenopathy Fevers Night sweats Weight loss
TB Epidemiological factors
History of prior TB infection
Known TB exposure
Residence or travel to areas where TB is endemic
Diagnosis of Pulmonary Tuberculosis
Patient’s meeting clinical criteria/history get chest radiography, if suggestive then
3 sputum specimens to run for isolation of M. tuberculosis
Tuberculin skin test as an adjunct
International Standards for Tuberculosis Management
Prompt diagnosis
Standard chemotherapeutic treatment regimens
Eradicate infection Prevent transmission Prevent relapse
Supervised treatment Monitored treatment response Public health measures
Chemo for TB - Two phases of drug therapy
Intensive phase ——-
Continuation phase——–
(2 months of daily dosing)—isoniazid, rifampin, pyrazinamide & ethambutol
(4-7 months of daily dosing) —isoniazid & rifampin
Active Pulmonary Infection
No —- dental treatment
elective outpatient
TB treatment drugs have adverse effects
Isoniazid, rifampin, & pyrazinamide————–
Rifampin———–
hepatotoxic
thrombocytopenia and leukopenia
Positive Tuberculin Skin Test
Patient should report that they had a ——-
Routine dental care with standard universal precautions
medical examination and chest x-rays
Positive Tuberculin Skin Test
Patient should report that they had a ——-
Routine dental care with standard universal precautions
medical examination and chest x-rays
Chronic viral hepatitis
\
78% of primary liver cancer
57% of cirrhosis (receive inadequate treatment)
HEP A & E =
infectious, fecal-oral route self-limited
•
HEP B, C, D =
serum, body fluids chronic infection
-cirrhosis & hepatocellular CA
HEP Pathophysiology
Not well understood
None of the 5 viruses are directly —–
Hepatocyte damage caused by —— secondary to immune activation.
cytopathic
inflammatory changes
Acute Viral Hepatitis
Clinical presentation:
highly variable, asymptomatic—severe disease
Acute Viral Hepatitis
Diagnosis
Antigen-antibody serologic tests to identify virus
Blood tests to assess the effect on the liver & amount of damage
Acute Viral Hepatitis
Tx
Palliative & supportive
Viral antigen & liver enzymes monitored for 6 months to follow resolution Watch for signs of acute liver failure
Chronic Viral Infection (Carrier)
—- signs of liver disease
6-10% HBV; 70-90% HCV
Can ——
No
persist or progress to chronic active hepatitis
