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PSBIM: Infectious Disease > Tuberculosis > Flashcards

Tuberculosis Flashcards

(58 cards)

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1
Q

Rasmussen’s aneurysm

A

Complication of PTB - rupture of dilated vessel in a cavity leading to massive hemoptysis

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2
Q

Ghon lesion

A

Small calcified nodule in primary PTB

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3
Q

Most potent risk factor for PTB

A

HIV coinfection

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4
Q

MDR-TB

A

Resistance to isoniazid and rifampicin

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5
Q

XDR-TB

A

Resistance to:

  1. Isoniazid and Rifampicin
  2. Fluoroquinolones
  3. 1 Aminoglycoside (amikacin, capreomycin or kanamycin)
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6
Q

Highly infectious TB

A

Cavitary PTB and laryngeal TB

10^5 to 10^7 AFB/ml

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7
Q

Ranke complex

A

Healed lesions in lung parenchyma and hilar lymph nodes which may later undergo calcification

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8
Q

Most common extrapulmonary TB

A

TB Lymphadenitis

LN > pleural > genitourinary > bone and joints > meninges > peritoneum > pericardium

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9
Q

Diagnostics for TB lymphadenitis

A

FNAB or excision biopsy

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10
Q

Diagnostics for pleural TB

A

Thoracentesis
Adenosine deaminase
Pleural biopsy

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11
Q

Diagnostics for genitourinary TB

A

Urinary: Isolate in culture of 3 morning urine specimen
Genital: Biopsy or culture

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12
Q

Most commonly affected joints by TB

A

Spine

Weight-bearing joints: Spine > Hips > Knees

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13
Q

Most commonly affected part of the spine by TB in adults

A

Lower thoracic and upper lumbar

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14
Q

Most commonly affected part of the hip joint by TB

A

Head of femur

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15
Q

Diagnostics for bone and joint TB

A

Aspiration or biopsy

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16
Q

Most commonly affected cranial nerve in TB meningitis

A

Ocular nerves due to involvement of meninges at the base of the brain

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17
Q

Diagnostics for TB meningitis

A

Gold standard: CSF culture

Preferred initial test: Xpert MTB/RIF assay

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18
Q

Most commonly affected part of the GIT by TB

A

Terminal ileum and cecum

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19
Q

Diagnostics for GIT TB

A

Biopsy (including peritoneum)

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20
Q

Diagnostics for TB pericarditis

A

2D echo-guided pericardiocentesis

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21
Q

Type of TB where glucocorticoid administration is life-saving

A

TB meningitis and TB pericarditis

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22
Q

Pathognomonic of miliary TB

A

Choroidal tubercles

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23
Q

Diagnostics for miliary TB

A

Bronchoalveolar lavage and transbronchial biopsy, liver or bone-marrow granuloma biopsy

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24
Q

Acute septicemic form of miliary TB

Study These Flashcards
A

Nonreactive miliary TB

25
IRIS (immune reconstitution inflammatory syndrome) or TB-IRD (TB immune reconstitution disease)
Exacerbations in symptoms, signs and laboratory or radiographic manifestations of TB associated with administration of ART Increased risk if earlier start of ART + lower baseline CD4
26
Dyes in AFB microscopy
Traditional: Ziehl-Neelsen basic fuschin | Modern labs: Auramine-rhodamine
27
Initial diagnostic test for new PTB case
AFB microscopy
28
Initial diagnostic test for MDR-TB, HIV-associated TB, TB meningitis, retreatment cases, failure cases
Xpert MTB/RIF assay
29
Definitive diagnostics for PTB
Isolation of M. tuberculosis from a specimen
30
Resistance genes for each anti-TB drugs
``` Rifampicin - rpoB Isoniazid - katG, inhA Pyrazinamide - pncA Ethambutol - embB Fluoroquinolones - gyrA-gyrB Aminoglycosides - rrs ```
31
Boosting phenomenon and True conversion for TST
Boosting phenomenon: Spurious TST conversion resulting from boosting of reactivity on subsequent TST 1-5 weeks after the initial test True conversion: After BCG vaccination in a previously TST-negative person in close contact of an infectious patient
32
Diagnostics for latent TB infection
Low- and middle-income: TST | Others: IGRA
33
Definition and Treatment for TB Category I
All new cases of PTB, all extrapulmonary TB except meninges, bone and joint 2HRZE / 4HR
34
Definition and Treatment for TB Category Ia
TB of the meninges, bone and joints 2HRZE / 9HR
35
Definition and Treatment for TB Category II
Retreatment of Category I 2HRZES / 1HRZE / 5HR
36
Definition and Treatment for TB Category IIa
Retreatment of Category Ia 2HRZES / 1HRZE / 9HR
37
Primary drug resistance to TB
Resistant strains in a patient with no treatment more than a month
38
Secondary drug resistance to TB
Resistant strains in a patient who has been taking or has taken anti-TB drugs for more than a month
39
Daily dose and max dose for each anti-TB drugs
``` Isoniazid: 5mkd, max 400mg Rifampicin: 10mkd, max 600mg Pyrazinamide: 25mkd, max 2000mg Ethambutol: 15mkd, max 1000mg Streptomycin: 15mkd, max 1200mg ```
40
Extended TB therapy
Indicated for: 1. cavitary PTB 2. silicotuberculosis 3. delayed sputum-culture conversion (culture-positive at 2 months) 4. pyrazinamide not included in initial treatment regimen Extend up to a total of 9 months
41
Reduced TB therapy
May be done for sputum culture-negative PTB Reduced to a total of 4 months
42
Persons at high risk of vitamin B6 deficiency
Alcoholics, malnourished, pregnant, lactating, chronic renal failure, DM, HIV infection
43
Monitoring schedule by AFB smear examination
New PTB cases: 2nd, 5th, 6th months **if not converted by 2nd month, repeat AFB smear on the 3rd month instead Retreatment cases: 3rd, 5th, 8th months
44
TB cured
Completed treatment PLUS 2x AFB sputum smear-negative if new PTB case 3x AFB sputum smear-negative if MDR-TB
45
TB treatment completed
Finished treatment but no confirmation bacteriologically
46
TB treatment failed
1. AFB sputum smear-positive on the 5th month | 2. Became smear-positive on the 2nd month when previously smear-negative
47
PTB treatment for patients with compensated liver cirrhosis
1. 2HES / 10HE 2. 2HRES / 6HR 3. 9HRE
48
PTB treatment for post-solid organ transplant patients
2HZE / 12-18HZE
49
Most common significant adverse reaction to anti-TB drugs and what to do when it occurs
Hepatitis Discontinue anti-TB drugs if AST/ALT 1. 3x elevated plus symptomatic 2. 5x elevated even if asymptomatic Stop pyrazinamide permanently
50
Contraindication for each anti-TB drugs
Rifampicin: autoimmune thrombocytopenia Pyrazinamide: Gouty arthritis (but not for asymptomatic hyperuricemia), severe liver failure Ethambutol: Optic neuritis Streptomycin: Ototoxicity
51
New TB case
Patients with less than 1 month TB treatment
52
TB retreatment
Patients with more than or equal to 1 month TB treatment, excluding prophylaxis or LTBI
53
Definition and treatment for TB relapse
Patients who had completed TB treatment previously and is with positive AFB sputum smears All 1st line drugs + streptomycin pending drug susceptibility testing
54
Lost to follow-up
Patients with more than or equal to 2 consecutive months interruption of treatment
55
When are TB patient deemed non-infectious
Bacteriologically-confirmed: After more than or equal to 14 days treatment Clinically-diagnosed: After more than or equal to 5 days treatment
56
Treatment regimen if with INH resistance
6RZE
57
Treatment regimen if with RIF resistance
2HES / 10HE
58
Treatment for latent TB infection
6H

PSBIM: Infectious Disease (9 decks)

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