Pulmonary Tuberculosis Flashcards

1
Q

In primary TB, the initial infection with tubercle bacilli is called ___

A

Ghon Focus

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2
Q

Primary TB is often seen in

A

Children

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3
Q

Ghon focus is usually seen in what part of the lungs

A

Middle and lower lung zones

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4
Q

Post-primary TB is often seen in what part of the lungs

A
  1. Apical and posterior segments of the upper lobe

2. Superior segments of lower lobes

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5
Q

In diagnosing presumptive TB, the cut-off age to be considered as adult is ___

A

15 years old

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6
Q

What are the criteria of Presumptive TB

A
  1. Cough at least 2 weeks
  2. Unexplained cough of any duration in a close contact of a known active TB case
  3. CXR suggestive of PTB with or without symptoms
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7
Q

What is the most common etiology of hemoptysis worldwide?

A

TB

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8
Q

What are the most common cause of hemoptysis in industrialized countries/

A

Bronchitis

Bronchiectasis

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9
Q

Massive hemoptysis is defined as blood loss of ___

A
  1. 400mL in 24 hours

2. 100 to 150 mL expectoration at one time

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10
Q

The primary diagnostic method to bacteriologically confrm TB is

A

Direct sputum smear microscopy

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11
Q

How will you conduct DSSM?

A

Same day Spot-spot strategy 1 hour apart, at least 5mL

At least one is positive

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12
Q

What is the best initial test to diagnose TB?

A

Gene X-pert MTB/RIF at least 1mL

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13
Q

What is the preferred screening test for latent TB infection in a resource limited setting?

A

TST

Alternative is IGRA

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14
Q

[TB Regimen]

New Pulmonary TB

A
2HRZE = 2 RIZE
4HR = 4 RI
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15
Q

[TB Regimen]

New miliary TB

A
2HRZE = 2 RIZE
4HR = 4 RI
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16
Q

[TB Regimen]

New EPTB except CNS, Bones, Joints

A
2HRZE = 2 RIZE
4HR = 4 RI
17
Q

[TB Regimen]

EPTB CNS, Bones, joints

A
2HRZE = 2 RIZE
10HR = 10 RI
18
Q

[TB Regimen]

Retreatment of rifampicin susceptible PTB and EPTB

except CNS, bones, joints

A
2HRZES = 2 RIZES
1HRZE = 1 RIZE
5HRE = 5 RIE
19
Q

[TB Regimen]

Retreatment of Rifampicin susceptible CNS, Bones, Joints TB

A
2HRZES = 2 RIZES
1HRZE = 1 RIZE
9HRE = 9 RIE
20
Q

[TB Regimen]

Dosing of isoniazid

A

5mg/kg

21
Q

[TB Regimen]

Dosing of Rifampicin

A

10mg/kg

22
Q

[TB Regimen]

Dosing of Ethambutol

A

15mg/kg

23
Q

[TB Regimen]

Dosing of Streptomycin

A

15mg/kg

24
Q

[TB Regimen]

Dosing of pyrazinamide

A

25mg/kg

Remember: HREZ 5 10 15 25

25
Q

[TB Regimen]

most hepatotoxic

A

Pyrazinamide

26
Q

[TB Regimen]

peripheral neuropathy

A

Isoniazid

inhibit mycolic acid synthesis

Give B6

27
Q

[TB Regimen]

Optic neuritis, decreased color perception

A

Ethambutol

inhibit arabinosyltransferase

28
Q

[TB Regimen]

Asymptomatic hyperuricemia

A

Pryazinamide

29
Q

[TB Regimen]

Autoimmune thrombocytopenia

A

Rifampicin

Blocks DNA-dependent RNA polymerase, most active

30
Q

Most common EPTB

A

TB lymphadenitis

31
Q

Most common location of skeletal TB

A

Thoracic and upper tumbar

32
Q

What is the cornerstone in diagnosing TB meningitis?

A

Lumbar puncture

33
Q

[TB Regimen]

MOA of streptomycin

A

binds at 30s