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Chapter 7 Pt.3
Tuberculosis
33
Other
Professional
03/05/2013

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Term
What is TB?
Definition
an important human disease caused by an infectious and communicable organism, Mycobacterium tuberculosis, spread by droplets
Term
How much of the world is infected with TB?
Definition
1/3
Term
What organs can TB include?
Definition
virtually any organ, but the lung is most common
Term
What is a Ghon complex?
Definition
The combination of a primary granulomatous lung lesion and an infected hilar lymph node
Term
How long after exposure will you test positive with a TB skin test?
Definition
2-8 weeks
Term
What is miliary tuberculosis?
Definition
Widespread infection with multiple organ involvement
Term
What happens if the infection is succesfully interupted?
Definition
lesion heals and undergo's calcification, if not the bacteria will spread
Term
Who is primary pulmonary Tb mostly seen in?
Definition
most often in infants and children; however, cavitation is rare in these age groups
Term
How is Tb different in young people than adults?
Definition
lymph node involvement not as common in young people
Term
What is the usual form of disease found in adults? What happens?
Definition
secondary TB, reactivation of the lesion occurs, infection relapses
Term
Common sequelae of Tb
Definition
-progressive primary TB
-cavitary disease
-pleurisy and pleural effusion -meningitis
-disseminated or miliary TB
Term
How many people who develop TB die?
Definition
5-10%, kills much more young people than AIDs
Term
What are the symptoms of primary TB?
Definition
-include cough
-lassitude and malaise
-anorexia
-unexplained weight loss
-night sweats, and fever
**positive skin test and radiograph test**
Term
What is the sputum like with progressive disease?
Definition
purulent
Term
What are lab tests directed towards?
Definition
finding out if it is active or latent TB
Term
When is is considered active?
Definition
a positive acid-fast bacillus sputum smear, a history of cough and weight loss, and characteristic chest radiographic findings
Term
What are the radiographic findings in TB like?
Definition
patchy or lobular infiltrates in the apical posterior segments of the upper lobes or in the middle or lower lobes, with cavitation and hilar adenopathy in active “progressive primary” TB
Term
Healed primary lesions have a...
Definition
Ghon Complex
Term
What are the two tests used for latent TB?
Definition
1.The tuberculin (Mantoux) skin test (TST)-measures delayed hypersensitiviy in 48-72 hours, 95% accurate
2.Interferon-gamma release assay (IGRA)-measure immune reactivity to white blood cells infected with M. tuberculosis
Term
What are some public health measures used for TB?
Definition
-Screening close contacts for the disease
-Hospitalizing patients with potentially infectious TB
-Treating infected patients in isolation rooms with negative air pressure
Term
What is the most threatening aspect of TB?
Definition
multiple drug resistance, seen in HIV patients
Term
Asymptomatic patients in whom skin testing (or IGRA) yielded a negative result that when repeated converted to positive are considered...
Definition
to be latently infected
Term
**All patients should be treated as though they are potentially infectious, and the CDC’s standard precautions for infection control should be strictly followed**
Definition
Term
Are we at high risk for occupational exposure to TB?
Definition
no, low risk
Term
What are the 4 categories of TB?
Definition
1.Active TB(ONLY treated in hospital setting)
2.A history of TB(MED CON,requires an initial careful workup to investigate infectivity status before any dental treatment is contemplated)
3.A positive tuberculin test
4.Signs or symptoms suggestive of TB
Term
A child with active TB who is receiving chemotherapy usually...
Definition
can be treated as an outpatient, because bacteria is usually not found in sputum (considered noninfectious until positive sputum, biggest concern is where they got it)
Term
Replase is BLANK in properly treated patients with TB.
Definition
-rare
-people who are immunocompromised or those who did not recieve adequate treatment can relapse
Term
Person with positive skin test should be viewed as...
Definition
having been infected with bacteria, need tests to see if it is active or latent, if latent we can treat them
Term
Isoniazid, rifampin, and pyrazinamide therapy cause what?
Definition
-hepatotoxicity and elevations in serum aminotransferases
**When serum aminotransferases are elevated in patients taking isoniazid, acetaminophen-containing medication should be avoided**
Term
What does Rifampin induce?
Definition
cytochrome p450 emzymes
Term
Routine treatment must be BLANK in those who are infectious.
Definition
delayed
Term
What are some oral manifestations of TB?
Definition
-The classic mucosa lesion is a painful, deep, irregular ulcer on the dorsum of the tongue (may be on palate, lips, buccal mucosa, gingiva also)
-osteomyelitis(from bacteria entering jaws)
-scrofula
Term
What is scrofula?
Definition
The cervical and submandibular lymph nodes become infected with TB
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