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15 Cards in this Set
- Front
- Back
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TB
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A chronic bacterial infection
Highly aerobic Mycobacterium... TB Bovis Ulcerans Kansasil Can be contracted by eating infected meat or milk |
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TB categories
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Primary
Postprimary Disseminated (spread brain, kidney, etc) |
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How can Primary TB be contracted?
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Inhaled droplet nuclei from infected individual (airborne route is most common)
Coughing Sneezing Laughing GI Tract (uncooked meat) Open skin wound |
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How Primary TB affects the lung
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Bacilli implants into the alv
3-4 week inflammatory response of lung similar to acute pneumonia with consolidation Mostly upper lobes infected Infection walls itself off forming a tubercle taking 2-10 weeks Coincides with a positive PPD test |
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How Postprimary TB affects the lung
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Live tubercle bacteria remains dormant for upto decades after initial infection was controlled
Tb becomes reactivated No one knows why Associated with weakened immune system (AIDS) Tubercle becomes a cavity and can rupture |
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Disseminated TB
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Extrapulmonary TB
Spreads from tubercle to other organs (kidneys, lymph nodes, GI tract, Brain, Meninges, ends of bones) via pulm lymphatics or bloodstream |
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Clinical Manifestations of TB
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Varies from none to acute onset suggestive of pneumonia
Low grade fever *Night sweats Listlessness *Loss of appetite *Weightloss Occasional cough |
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Diagnosis of TB
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Intradermal (Mantoux) Tuberculin Skin Testing PPD
Acid-Fast stain Sputum culture CXR |
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PPD
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Purified Protein Derivative
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Gram stain on TB
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Does not work
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Intradermal (Mantoux) Skin Test
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PPD
Injection of PPD bacilli under skin - forearm Observe skin for 48-72 hrs for an area of induration (bump) Less than 5mm: neg 5-9mm: suspicious, repeat test 10 of higher: positive for past or recent exposure -does not confirm active TB -does not mean person has developed cell-mediated immunity |
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Acid Fast Stain
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Ziehl Neelson: Bright red acid-fast bacilli against blue background
Fourescent acid fast stain: Luminescent yellow green bacilli against a dark brown background |
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Culture to ID strain
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6-8 weeks the old way
24 hrs the new way Determine ABX sensitivity or resistance |
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CXR TB
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Cavity formation mostly in upper lobes
Calcification and fibrosis around lesion Possible pleural thickening |
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Manage Primary TB
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Resp Isolation (neg. pressure room)
Pharmacologic agents (chemo) -combo of 2-4 drugs given for 6-12 months -Third agent added (Ethambutol, streptomycin, Pyrazinamide) No longer contagious after several week of chemo - must comp. Rx regimen |
