• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

image

PLAY BUTTON

image

PLAY BUTTON

image

Progress

1/12

Click to flip

Card Range To Study

through

12 Cards in this Set

  • Front
  • Back
Why did case rates of Tb increase in the US in the 1990s?
Appearance of HIV-->increased risk of progression to disease

Migration to US from SE Asia (higher prevalence of Tb there)

Crumbling health infrastructure in marginalized populations
How is Tb spread?
Which form of Tb is spread?
Person to person
Must have PULMONARY Tb
Organism is spread via aerosolized droplet nuclei that remain in air for up to 6 hours after coughing/breathing/sneezing

Transmission DOES NOT occur by fomites
What events occur once someone has inhaled pulmonary Tb droplet nuclei--end with Tb's dormant state.

Where does Tb lie dormant?
-Organism is inspired into LOWER LOBES
-Alveolar macs and WBCs phagocytize
-Carried to lymphatics, systemic circuln
-Cell-mediated immunity act'd, organism becomes dormant (most commonly in apices of lung, long bone or kidneys--areas of high O2 tension)
In immunocompetent patient, what is risk of developing Tb while Tb is in latent form?
10% risk that fluctuates over lifetime; 5% will progress after 2 years, 5% will progress within 2 years

Diabetes increases risk by 3 fold, while HIV increases risk by 100 fold
Where can Tb infection occur?
Anywhere (systemic circulation), but occurs most commonly in lungs.

80% occurs in lungs, 20% elsewhere, e.g., eyes.
Exposure to Tb can lead to ________, which leads to _________, and can result in ___________.
Exposure-->Infection-->Disease-->Contagion

Only pulmonary cases are contagious!
Which epidemiologic groups are at risk for developing Tb (in the US)?

Presentation of Tb?
At risk groups: foreign born, HIV, DM, chronic renal failure, steroid use

Presentation: non-specific; chronic febrile illness unresponsive to abx
Clinical manifestations of Tb in pulmonary system.
Chronic cough, fever, weight loss

May not have syx if early in dz
Diagnosis of Tb
Gold standard-->culture (slow; takes up to 6 weeks)

Mostly depends on physician's suspicion
Treatment of Tb (latent vs cavitary Tb disease)
INH, Rifampin at least 6 months

If Latent and 10-100 organisms present, use 1 drug.

If Cavitary and 100 billion organisms present, use 2 drugs.

Do not uncouple or will risk mutation and drug resistance!
What is the main challenge to Tb control?
Adherence to tx
Utility of BCG Vaccine
Not the same globally due to genetic shift.

Modulates Tb disease at childhood; if get Tb under 2 years of age, don't have developed immune response, and can result in TB meningitis. BCG vaccines prevents the meningitis.

Doesn't prevent TB infection, or TB in adults.

Effect wanes with time.