Flashcards in Tuberculosis Deck (24):
Risk factors for TB?
Poverty, HIV, MRD strains, Immunocomprime, Substance abuse, malnutrition, underlying chronic disease, young>older, male>women, living in close quarters with TB + , minority, crowded living facilities
Primary organism that causes TB?
Mycobacterium tuberculosis, acid-fast bacilli
Other organisms that cause TB?
Mycobacterium africanum and Mycobacterium bovis
Modes of transmission of TB?
Through respiratory droplets. Coughing, talking, singing, intubation, bronchoscopy, aerosol treatments, autopsy
How long can TB remain infectious in the air?
4 outcomes when exposed to TB?
Clear the infectious organism resulting in no disease, primary disease, latent infection, reactivation of TB
Pathophysiology of infection?
Bacteria carried to lungs where it proliferates in macrophage. Macrophage produces cytokines and chemokines, which attract other macrophages and neutrophils, and monocytes. Tubercle is formed enclosing these cells.
When the tubercle expands and causes a lesion into the lung it is called?
These individuals who have latent TB are at a high rate for reactivation.
Immunosuppressed patients (HIV, Lymphoma, smokers, DM, ESRD)
Primary tuberculosis refers to a _______ blank infection.
What are CXR characteristics in people with TB?
Unilateral hilar adenopathy, lower and upper infiltrates, upper lobe abnormalities more common
Which lung is more commonly infected?
Patients with primary TB can develop these additional disease?
Meningitis, pericarditis, further lung cavitation of lung tissue
Patients with reactivation present ____ years after initial infection with these symptoms and signs?
2 years, cough (worsens to produce green-sputum or hemoptysis), night sweats, anorexia, weight loss, fever
Abnormal lung findings with reactivation TB?
Rales, whispered pectoriloquy, dullness, distant hollow breath sounds in cavitation
This extrapulmonary manifestation presents with hematogenous spread of tuberculosis to pulmonary tissue?
Extrapulmonary tuberculosis examples?
Meningitis, miliary TB, scofula (of neck), TB pleurisy, Potts disease, urogenital TB
Does treatment of latent TB mean that the patient is cured?
No it just reduces the risk of reactivation but does not reduce risk to zero
Medications and duration of treatment for TB
Isoniazid (INH) 9-6 months, Rifampin 4 months
Side effects of isoniazid (INH)
Elevated live enzymes, peripheral neuropathy (2%), 1:1000 drug induced hepatitis, NO ALC on medication
Side effect of rifampin?
Small chance of hepatotoxictiy, multiple drug interactions, turns body fluids orange
Drug combination therapy for latent TB which requires DOT?
Isoniazide + Rifapentine for 3 months via DOT
Side effects of isoniazide + rifapentine?
Flu like reaction, drug reaction, hypotension, syncope