Flashcards in Tuberculosis Deck (26):
Suspect TB – Next step?
Serial sputum samples for culture
Describe lesions in primary TB?
Lesions form in periphery with hilar and paratracheal lymphadenopathy
(Affects middle and lower lung zones)
Histology of lesions?
Caseating Granulomas (Liquefied center forms cavity)
Healed TB lesions are called?
Reactivation TB usually involves?
Apical and posterior segments of upper lobes (Or superior segments of lower lobes)
Symptoms of TB?
Rupture of dilated vessels in a TB cavity
Physical findings in TB?
Finger clubbing from Hypoxia
Lab findings in TB?
Hyponatremia from SIADH
Sites of extrapulmonary TB?
1. Lymph nodes (Painless adenopathy)
3. GU tract
Supplemental therapy in TB meningitis?
Signs of genitourinary TB?
Dysuria, hematuria, urinary frequency
Characteristic lab findings in genitourinary TB?
Leukocytes negative bacterial cultures (sterile pyuria)
Milliary TB occurs by?
If pulmonary TB is suspected, next steps?
Three samples of early morning sputum
Place patient in isolation
Treatment for TB?
Six-month course of RIPE
Positive PPD is defined by?
Induration after 48 to 72 hours and is 5 mm or greater in:
1. Patients with HIV
2. Close contacts of patients with TB
3. Patients with chest x-ray findings consistent with TP
4. Steroid users or transplant recipiants
10 mm or greater patients who are healthcare workers, prisoners, cancer, diabetes, alcoholics, recent immigrants
15 mm or greater than everyone else
Treatment for latent TB?
Isoniazid for nine months
Patient treated for tuberculosis should also receive?
Pyridoxine (vitamin B6), which is Deficient from isoniazid therapy
Considerations to consider when treating women for TB?
Oral contraceptives may reduce Blood levels
Patient is PPD positive but has had previous BCG vaccine. Management?
BCG vaccine does not change management (isoniazid)
Patient with suspected TB;
1. Best initial test?
2. Most accurate test?
2. Pleural biopsy
Active TB treatment?
Rifampin (6 mo)
Isoniazid (6 mo)
Pyrazinamid (4 mo)
Ethambutol (4 mo)
Side effects and management of:
1. Red color (none)
2. Peripheral neuropathy (give B6)
3. Hyperuricemia (none, unless symptomatic)
4. Optic neuritis (Decrease dose)
When to use steroids?
#Pericardial involvement (decrease restrictive pericarditis)
#TB meningitis (decrease neuro complications)