Shared Flashcard Set

Details

case 3
present
18
Medical
Graduate
09/14/2011

Additional Medical Flashcards

 


 

Cards

Term
Tuberculosis is a common infectious disease most typically transmitted from a person with active tuberculosis (TB) by
Definition
inhaling airborne bacilli
Term
As a clinician, you should have a high suspicion for TB in patients displaying a chronic cough and having which of the following risk factors
Definition
homelessness
Term
What is the causative agent for a TB infection?
Definition

bacterium

mycobacterium tubercolosis

Term
During the physical examination of a patient presenting to the outpatient clinic for unresolved cough, what can you say about the physical examination of patients with TB
Definition

often entirely normal

 

note: a patient may present to the clinic for any reason and unless typical signs of TB are present, the exam could be entirely normal. Thus when patient comes in with unresolved cough in absence of possible high risk association (e.g. homelessness, immunosuppression, HIV positive persons…etc. etc.) a “normal exam” should not automatically exclude the potential presence of TB.

Term
Based on the presentation of 3rd case, the patient indicated that his medications included “riff” and “isso…something…” Which of the following pairs would be the most typical regimen the patient would be on for treatment of TB?
Definition
rifampin isoniazid
Term
ESR stands for which of the following?
Definition
erythrocyte sedimentation rate
Term
The Trendelenburg sign (not the Trendelenburg test!) is useful for determining weakness of which of the following muscles?
Definition
hip abductor
Term

 

In the review of systems, a patient indicates the presence of fatigue, weight loss, and nocturnal sweating. This information is collectively known as __________ signs/symptoms?

Definition
constitutional
Term
n the patient presented in Case Number 3, which of the following information would best suggest that something of a sinister pathology is going on.
Definition
groin pain at rest
Term
Psoas muscle abscess caused by TB
Definition

backpain

fever

groin pain

increase frequency

abdominal pain

 

distal extension of psoas abscess may present with an mass in the inquinal region

Term

movement of hip is :

 

PAINLESS in psoas abscess

PAINFUL in spetic arthritis

Definition
Term

confirm psoas abscess Dx

and treatment

 

Definition

high clinical suspicion

imaging studies: ultrasound, CT(more sensitive)

 

Treatment: DRAINGAGE, ANTIBIOTIC

Term
primary vs. secondary psoas
Definition

PRIMARY PSOAS

SECONDARY PSOAS

Most cause by staphylococcus aureus

Cause by enteric (GI) bacteria such as E. Coli

 

Cause by M. TB infection ( usually associate with pulmonary finding, but can be found in many organ)

 

Other condition caused by ascess: diverticulitis, appendicitis, Crohn’s disease, UTI, vertebral osteomyelitis, septic arthritis.

Term
DX TB
Definition

clinical one based on history, physical sign/symptom relate to site of disease

 

chest radiography alone often not distinguish between inactive vs active pulmonary TB

 

positive sin test show infection with TB but not diagnose active disease

 

 

Term
detection of TB
Definition

- high quality, sponstanoeus expectorated (cough out) sputum (respiratory tract mucus) is preferred for detection of ACID FAST baccili on smear

 

- Positive AFB smear makes a presumptive dx of TB in high risk patient. although a positive stain smear is not specific for M. TB

 

Term
"Gold Standard" for diagnosis of TB
Definition
is culture isolation of organism from secretion or from tissue/fluid sample
Term
rifampin
Definition
may cause acute renal failure, infrequent severe side effect, nephrotoxicity is very rare with INH (isoniazid)
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