TB(1247 exam 1)

  1. what is the leading cause of death in hiv pt?
  2. who is at high risk for TB
    • homeless
    • inner city
    • long term
    • forien
    • institutions
    • iv drug user
    • poverty
    • diabetes
    • hiv/aids
    • immunosup
  3. what organism causes TB
    • M tuberculosis
    • gram+
    • acid fast
    • bacillus
    • AFB
  4. factors that contribute to the reemergence of TB
    • HIV pt w TB
    • MDR strains
  5. how is TB transmitted
    • airborne
    • droplets can remain suspended for min-hours but replicate slow
  6. is TB highly infectious
  7. what can trigger reactivation of latent tb infection
    host defenses become impaired
  8. tb initial s/s
    • cough that becomes productive
    • fatigue
    • anorexia
    • unexplained weight loss
    • low grade fever
    • night sweats
  9. tb late s/s
    • dyspnea
    • emoptysis
    • chest wall pain
  10. tb usually heals ____
    without complications except for scaring
  11. tb complications
    • military tb
    • pleural tb
  12. military TB
    • spreads to other organs via blood stream
    • can be fatal if untreated
  13. pleural tb effusion and empyma
    • bacteria in pleural space
    • inflammatory reponse
    • fluid or pus in pleural space
  14. how long does it take for antibody formation to occur after initial exposure
    2-12 weeks for + skin test
  15. how is tb skin test performed
    • -intradermal injection of 0.1 ml PPD antigen
    • -ventral surface of the arm
  16. how ong to wait to to read skin test
    48-72 hours
  17. what do you measure on skin test
    • induration
  18. tb skin test positive reaction readings
    • 5mm:if high risk person
    • 10mm: if moderate risk person
    • 15mm: if low risk person
  19. what the tb skin test does not do
    does not differenciate between active disease and latent tb infection
  20. high risk person
    moderate rik person
    low risk person
    • -immunocomp, recent tb contact, lesion on xray
    • -immigrant, iv drug user, workers, clinical disease
    • - healthy,no risk factors
  21. false positive possible cause
    • nonTB mycobacterium
    • BCG vaccination
  22. false negative possible cause
    • recent tb infection
    • very young <6mo old
    • anergy(cant react to skin test because of weak immune system)
  23. anergy
    (cant react to skin test because of weak immune system)
  24. who will have a positive test
    • BCG vaccine
    • active tb disease
    • latent tb infection
  25. when would HCP order further testing
    • -positive skin test
    • -s/s of tb with negative skin test
  26. Chest xray for TB
    • -cant diagnos because other diseases can mimic tb
    • - cxr could be normal even if someone had tb
  27. sputum and smear culture for tB diagnosis
  28. sputum and smear culture

    • -take sputum swab on 3 consecutive days
    • -initially do stained sputum smear for acid -fast bact(AFB)
    • -grow sputum culture for m.TB
  29. how long could sputum and smear culture take to grow
    8 weeks
  30. what are the TB blodd tests
    • IGRA
    • QFT-GIT
    • Tspot
  31. if the patient is infected with tb, ____ will secrete____
    • lymphocytes
    • interferon
  32. why to use tb blood test
    • requires 1 visit
    • not affected by BCG vaccination
  33. tx for active tb initial phase

    -how long
    • -4 med therapy
    • -8 weeks
    • -isoniazid, rifampin, pyrazimide, ethambutol
    • -liver(hepatitis)
  34. which stage of TB should you be more aggressive with tx
  35. continuation phase of tb

    • -d/c ethambol, continue other 3
    • -18 weeks
    • -feel better
  36. when is TB pt considered non infectious
    when they have a (-) sputum culture X2 consec months or after 2 weeks
  37. what is criteria for latent TB
    person has been infected with tb but does not have the disease. exposure
  38. latent tb

    • -1 med, no MDR
    • -INH
    • -6-9 months
  39. s/s of latent TB
  40. prevention of TB
    -BCG vaccine(infants)
  41. BCG vaccine facts
    • -not typically given in USA
    • -cause false positive tb skin test
    • -does not effect tb blood test IGRA
  42. factors that can reactivate TB
    • stress
    • smoking
    • respiratory disease
  43. what are the two types of TB infection
    primary and latent
  44. what is the difference between primary and latent tb and are they the infection or the disease

    primary: no s/s, bacteria is encapsulated, immune system fights, (-) skin test

    latent: encapsulates but does not destroy, no s/s, lays dormant, (+) skin test
  45. is skin test + or - for

    primary tb
    latent tb
    • -
    • +
  46. what is the biggest difference between tb infection and tb disease
    • tb infection= no s/s
    • tb disease= s/s
  47. what is tb disease
    virus has replicated, + skin test, s/s are present
  48. what is the order in which the organism enters the body
    • 1) inhaled
    • 2)inflammatory
    • 3) granuloma
    • 4)calcification
    • 5) replication inhibited
  49. what is the hallmark of primary tb infection
    formation of granuloma which is the defense mechanism
  50. class rank for TB
    • 0-5
    • 0-no exposure
    • 1-exposure no infection(primary)
    • 2-LTBI- infection w/o disease, only +skin text
    • 3-tb clinically active- disease, s/s, + tests
    • 4- tb but not clinically active- hx of previous disease
    • 5- tb suspect- s/s, waiting on results
Card Set
TB(1247 exam 1)
TB(1247 exam 1)