Tuberculosis Pneumonia

Front 1

Fourth leading cause of death from ID.

Back 1

TB

Front 2

How many people worldwide are infected w/ TB?

Back 2

2 billion

Front 3

How many new cases of TB are found each year?

Back 3

9 million

Front 4

Mycobacterium tuberculosis is spread through _____ .

Back 4

the air by droplets

Front 5

____ droplets are more likely to be infectious.

Back 5

Small

Front 6

T/F: Once droplets hit the ground they are no longer infectious.

Back 6

False, on the ground the droplets dessicate and dry bacteria can be blown around and inhaled

Front 7

Causes bovine TB and is spread through milk products, used to immunize people in some parts of the world

Back 7

M. bovis

Front 8

If you are exposed to TB there is a ___ chance of infection.

Back 8

30%

Front 9

Of those infected w/ TB ___ will get early progression TB.

Back 9

5%

Front 10

___ of those infected w/ TB will get late progressive TB.

Back 10

5%

Front 11

Lifetime risk for an infected individual of developing active TB is ____

Back 11

10%

Front 12

If HIV positive, there is a ___ ANNUAL risk or progression to active disease.

Back 12

10%

Front 13

As CD4 counts fall, TB is one of the ____ infections to appear.

Back 13

earliest

Front 14

In full blown AIDS patients, they are less likely to form ___ w/ TB.

Back 14

cavities

Front 15

Very important to watch patients swallow pills.

Back 15

Direct Observed Therapy

Front 16

First line TB drugs:

Back 16

isoniazid, rifampin, pyrazinamide, ethambutol, streptomycin

Front 17

Second line TB drugs:

Back 17

capreomycin, amikacin, kanamycin are injectable
fluoroquinolones, cycloserine, ethionamide, para-aminosalicylic acid

Front 18

Maximum benefit was found w/ this duration of treatment.

Back 18

9 months

Front 19

What is causing the new TB epidemic?

Back 19

decline in public health infrastructure, increased immigration, HIV, MDR

Front 20

MDR is resistant to ____ and ___.

Back 20

rifampin and isoniazid

Front 21

TB treatment is always given in _____.

Back 21

combination

Front 22

Primary resistance is seen in an ____ patient.

Back 22

untreated

Front 23

Secondary resistance is someone w/ ______.

Back 23

at least 30 days of treatment of TB

Front 24

TB gets into the lymphatics and drains into the bloodstream for _____ weeks b/f an immune response is generated.

Back 24

6-8

Front 25

T/F: If you are infected w/ TB but do not have the active disease, you are still infectious.

Back 25

False, you are not infectious,

Front 26

Sputum smear will be ___ in an infected person w/o active disease.

Back 26

negative

Front 27

CXR in an infected person w/o active disease.

Back 27

usually normal

Front 28

PPD skin test is usually ____ in an infected person w/o active infectino.

Back 28

positive

Front 29

Symptoms of TB

Back 29

prolonged, productive cough
deep chest pain
hempoptysis-very sensitive

Systemic: fever, chills, night sweats, appetite/weight loss, easy fatigability

Front 30

The systemic symptoms of TB can be consued w/?

Back 30

lymphoma

Front 31

How to diagnose TB

Back 31

PPD test, CXR, sputum smear, cultures

Front 32

What is the only absolute confirmation of TB?

Back 32

cultures

Front 33

Acid fast stain will pick up ____

Back 33

TB, along w/ atypical mycobacteria, Nocardia, and Rhodococcus

Front 34

In a PPD test make sure to measure the diameter of the _____

Back 34

induration

Front 35

T/F: Once you have a positive PPD test, you should be retested annually.

Back 35

False, every time you test it activates more memory cells and you can develop a significant response.

Front 36

Abnormalities on CXR are seen in ____

Back 36

apical and posterior segements of upper lobes or superior portions of lower lobes

Front 37

T/F: A positive CXR is not confirmation of TB.

Back 37

True, only culture

Front 38

What else can cause solitary lung lesions like TB?

Back 38

histoplasmosis

Front 39

Calcification of lobe site due to prior infection w/ TB

Back 39

Ghon focus

Front 40

Calcification of lobe along with lymph nodes due to prior TB infection

Back 40

Ranke complex

Front 41

A ___ stain can increase sensitivity by 10-20% or AF stain.

Back 41

fluorochrome

Front 42

TB causes ____ necrosis in lung tissue.

Back 42

caseating

Front 43

Most cavities begin in the ____

Back 43

periphery

Front 44

If cavity invades bronchus then patient develops

Back 44

hemoptysis

Front 45

TB of spine

Back 45

Pott's disease

Front 46

Only confirmatory test and only way to speciate, required for drug susceptibility tests

Back 46

Cultures

Front 47

Liquid/Solid media grows TB better?

Back 47

liquid

Front 48

____ are more likely to have severe diffuse TB w/ TB meningitis, bone and joint involvement, or disseminated TB

Back 48

Children

Front 49

Children are treated for ___ months compared to ___ months for adults.

Back 49

9-12; 6

Front 50

TB drugs interfere w/ ____.

Back 50

protease inhibitors