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Flashcards in Tuberculosis Deck (26):
0

Suspect TB – Next step?

Serial sputum samples for culture

1

Describe lesions in primary TB?

Lesions form in periphery with hilar and paratracheal lymphadenopathy

(Affects middle and lower lung zones)

2

Histology of lesions?

Caseating Granulomas (Liquefied center forms cavity)

3

Healed TB lesions are called?

Gohn lesions

4

Reactivation TB usually involves?

Apical and posterior segments of upper lobes (Or superior segments of lower lobes)

5

Symptoms of TB?

Constitutional symptoms
Hemoptysis
Purulent sputum

6

Rasmussen aneurysm

Rupture of dilated vessels in a TB cavity

7

Physical findings in TB?

Fever
Wasting
Rales/rhonchi
Finger clubbing from Hypoxia

8

Lab findings in TB?

Leukocytosis
Anemia
Hyponatremia from SIADH

9

Sites of extrapulmonary TB?

1. Lymph nodes (Painless adenopathy)
2. Pleura
3. GU tract
4. Bones/joints
5. Meninges
6. Peritoneum

10

Supplemental therapy in TB meningitis?

Glucocorticoids

11

Signs of genitourinary TB?

Asymptomatic or
Dysuria, hematuria, urinary frequency

12

Characteristic lab findings in genitourinary TB?

Leukocytes negative bacterial cultures (sterile pyuria)

13

Milliary TB occurs by?

Hematogenous dissemination

14

If pulmonary TB is suspected, next steps?

Three samples of early morning sputum
Place patient in isolation

15

Treatment for TB?

Six-month course of RIPE
Rifampin
Isoniazid
Pyrazinamide
Ethambutol

16

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

17

Treatment for latent TB?

Isoniazid for nine months

18

Patient treated for tuberculosis should also receive?

Pyridoxine (vitamin B6), which is Deficient from isoniazid therapy

19

Considerations to consider when treating women for TB?

Oral contraceptives may reduce Blood levels

20

Patient is PPD positive but has had previous BCG vaccine. Management?

BCG vaccine does not change management (isoniazid)

21

Patient with suspected TB;
1. Best initial test?
2. Most accurate test?

1. CXR
2. Pleural biopsy

23

Active TB treatment?

RIPE
Rifampin (6 mo)
Isoniazid (6 mo)
Pyrazinamid (4 mo)
Ethambutol (4 mo)

24

Side effects and management of:
1. Rifampin
2. Isoniazid?
3. Pyrazinaminde?
4. Ethambutol?

1. Red color (none)
2. Peripheral neuropathy (give B6)
3. Hyperuricemia (none, unless symptomatic)
4. Optic neuritis (Decrease dose)

25

When to use steroids?

#Pericardial involvement (decrease restrictive pericarditis)
#TB meningitis (decrease neuro complications)

26

Need longer (9 month) treatment in pts with?

#osteomyelitis
#miliary TB
#Meningitis
#Pregnancy

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