Tuberculosis

Question 1

T/F: TB is the 2nd most common cause of infectious deaths worthwide

Answer 1

true

Question 2

how much of the world population is estimated to be infected with latent TB?

Answer 2

1/3rd

Question 3

TB vaccine

Answer 3

Bacille Calmette-Guerin (BCG)

Question 4

what bacteria causes TB?

Answer 4

mycobacterium tuberculosis

Question 5

how is TB spread?

Answer 5

via inhalation of infected droplets

Question 6

what happens when TB is deposited in the lungs?

Answer 6

1. immediate clearance of organism
2. primary disease
3. latent infection
4. reactivation disease

Question 7

what percentage of ppl who have deposition of the bacteria in their lungs resulted in primary disease?

Answer 7

5-10%

Question 8

what percentage of ppl with deposition of the bacteria in the their lungs are asymptomatic?

Answer 8

90%

Question 9

what are the syms of primary disease?

Answer 9

same syms as infectious disease

* fever, malaise, etc

Question 10

what is the occurance rate of the disease reactivating?

Answer 10

5-10%

Question 11

latent infection

Answer 11

bacteria still replicating but the body walls them off in granuloma
- does not cause syms

Question 12

clinical manifestations of pulmonary TB

Answer 12

• cough >2-3 wks duration
• lymphadenopathy
• fevers
• night sweats
• weight loss

Question 13

epidemiologic factors of pulmonary TB

Answer 13

• history of prior TB infection
• known TB exposure
• residence or travel to areas where TB is endemic

Question 14

diagnosis of pulmonary TB

Answer 14

• pt’s meeting clinical criteria/history… get chest radiography if suggestive then
• 3 sputum specimens to run for isolation of M. tuberculosis
• tuberculin skin test as an adjunct

Question 15

is tuberculin skin test a confirmation of disease?

Answer 15

NO, not complete firm positive

Question 16

tuberculin skin test

Answer 16

• delayed hypersensitivity response

- induration >24 hrs later

Question 17

positive individuals of tuberculin skin test

Answer 17

• infection w/ non-tuberculosis mycobacteria
• previous BCG vaccination
• previous infection w/ M. tuberculosis

Question 18

international standards for tuberculosis management

Answer 18

• prompt diagnosis
• standard chemotherapeutic txtment regimens
• supervised txtment
• monitored txtment response
• public health measures

Question 19

what are the goals of the standard chemotherapeutic txtment regimens?

Answer 19

1. eradicate infection
2. prevent transmission
3. prevent relapse

Question 20

what are the two phase of drug therapy for TB?

Answer 20

1. intensive phase

2. continuation phase

Question 21

how long is the intensive phase?

Answer 21

2 months of daily dosing

Question 22

what drugs are taken during the intensive phase?

Answer 22

• isoniazid
• rifampin
• pyrazinamide
• ethambutol

Question 23

how long is the continuation phase?

Answer 23

4-7 months of daily dosing

Question 24

what drugs are taken during the continuation phase?

Answer 24

• isoniazid

- rifampin

Question 25

completion of chemotherapeutic therapy is determined by?

Answer 25

having 2 consecutive negatives of sputum culture

Question 26

what percentage of compliant pts become non-infectious within first 3 months?

Answer 26

90%

Question 27

effective chemotherapy

Answer 27

- pt education and compliance - appropriate drug selection - multiple drug use - sufficient length of course

Question 28

what is a reason for reactivation of disease?

Answer 28

pts are not compliant with meds

Question 29

can you treat a pt with active pulmonary infection?

Answer 29

no elective outpatient dental txtment

Question 30

txtment for active pulmonary infection

Answer 30

- airborne isolation in hospital setting | - TB drug regimen

Question 31

which TB drugs are hepatotoxic?

Answer 31

- isoniazid - rifampin - pyrazinamide

Question 32

which TB drugs are thrombocytopenia and leukopenia?

Answer 32

rifampin

Question 33

if pt was previously treated for TB, would they have positive tuberculin skin test from now on?

Answer 33

yes, will always have a positive skin test | *once have hypersensitivity rxn, will always be positive

Question 34

can you treat a pt with a positive tuberculin skin test?

Answer 34

yes

Question 35

mods to dental txtment

Answer 35

following universal precautions is adequate

Question 36

dental offices are considered what type of risk for occupational exposure according to the CDC?

Answer 36

low