BT

What is tuberculosis (TB)?

A contagious chronic bacterial infection that primarily affects the lungs.

What is the TB pathogen?

Mycobacterium tuberculosis, a rod-shaped bacterium with a waxy capsule.

What are the classifications of tuberculosis?

Primary TB, Reactivation TB, Disseminated TB.

What occurs during primary tuberculosis?

It follows the first exposure to TB pathogen, with inhaled bacilli implanting in the alveoli and multiplying.

What is a tubercle?

A protective cell wall produced around the TB infection that contains caseous necrosis and TB bacilli.

What is latent TB?

When the TB bacilli remain dormant after being isolated within tubercles and immunity develops.

What risk factors are associated with reactivation tuberculosis?

Malnourishment, overcrowded conditions, immunosuppression, and HIV.

What does disseminated tuberculosis refer to?

Infection from TB bacilli that escape a tubercle and travel throughout the body via the bloodstream or lymphatic system.

What are common locations for disseminated TB?

Apex of the lungs, regional lymph nodes, kidneys, long bones, genital tract, brain, and meninges.

What are anatomical alterations of the lungs in moderate to severe reactivation TB?

Alveolar consolidation, alveolar-capillary destruction, cavity formation, and fibrosis.

How many new cases of TB were reported in the US in 2019?

8,916 new cases.

What percentage of the world's population is infected with Mycobacterium tuberculosis?

About 25% of the world’s population.

What is the Mantoux tuberculin skin test?

Test involving injection of purified protein derivative (PPD) to check for TB infection.

What size induration is considered a positive result in the Mantoux test?

An induration of 10 mm or greater.

What is an acid-fast bacilli (AFB) test?

Test performed on sputum to check for the presence of TB organisms.

What are some clinical manifestations associated with tuberculosis?

Alveolar consolidation, increased alveolar-capillary membrane thickness.

What are vital signs indicators for TB during a physical examination?

Cyanosis, cough, sputum production, digital clubbing.

What pulmonary function test findings are indicative of moderate and extensive TB cases?

Decreased FVC, FEV1, and lung volumes such as IRV and VC.

What characterizes the arterial blood gas findings in extensive tuberculosis with pulmonary fibrosis?

Chronic ventilatory failure with hypoxemia and compensated respiratory acidosis.

What are abnormal laboratory tests indicative of TB?

Positive tuberculosis skin test, positive sputum AFB stain test, positive culture.

What are some radiologic findings in TB?

Increased opacity, Ghon nodules, cavity formation, pleural effusion.

What is the first-line treatment duration for TB?

6 to 9 months using a combination of 2 to 4 drugs.

What is included in the 6-month treatment protocol for TB?

An induction phase with isoniazid, rifampin, pyrazinamide, and either ethambutol or streptomycin.

Why is noncompliance in TB therapy a major concern?

Because it affects the effectiveness of treatment and may lead to drug resistance.

What is directly observed therapy (DOT) in TB management?

A method where a responsible individual directly observes the patient taking their medication.

What protocols are included in respiratory care treatment for TB?

Oxygen therapy, airway clearance therapy, mechanical ventilation protocols.

What happens during the reactivation stage of TB?

TB reappears months or years after the initial infection has been controlled.

What is caseous necrosis?

A form of tissue necrosis that appears cheese-like (caseous) and is associated with tuberculosis.

What is the function of a tubercle in TB infection?

To contain TB bacilli and prevent their further spread.

What are Ghon complexes?

Radiologic findings of TB consisting of a primary focus of infection and lymph node involvement.

What is MDR-TB?

Multidrug-resistant tuberculosis, a form of TB that is resistant to at least isoniazid and rifampicin.

What is the role of rifampin in TB treatment?

It is a bactericidal drug commonly used in combination with isoniazid.

What happens if TB is resistant to first-line agents?

At least three or more antibiotics must be added to the treatment regimen.

What is significant about the cough in TB patients?

It may produce sputum and can sometimes lead to hemoptysis.

What are pitting edema and distended neck veins a sign of in TB patients?

Possible right heart failure or fluid overload due to severe lung disease.

What does the presence of crackles and wheezing indicate in a TB patient?

Airway obstruction or inflammation associated with lung disease.

What can cause hypercapnia in TB patients?

Ventilation-perfusion mismatch leading to chronic ventilatory failure.

What is the potential consequence of untreated TB infection?

Progression to more severe forms of the disease, including reactivation or disseminated TB.

What does the increased tactile fremitus indicate during a physical exam?

Consolidation or solidification of lung tissue due to infection.

What other organs can be affected by disseminated TB?

Kidneys, brain, meninges, and gastrointestinal tract.

What are common symptoms during the primary stage of TB?

Cough, fever, night sweats, and weight loss.

What is the purpose of sputum cultures in TB diagnosis?

To confirm the presence of Mycobacterium tuberculosis.

What are the treatment options for latent TB?

Isoniazid and rifapentine for 12 weeks or isoniazid for 6-9 months.

What does the QuantiFERON-TB Gold test detect?

It detects the immune response to specific TB antigens.

What is the significance of caseous tubercles?

They indicate the body's attempt to contain TB infection.

What factors increase the risk of developing TB in individuals?

Immunocompromisation, malnutrition, and living conditions.

What is the main goal of TB treatment?

To eliminate the bacterium from the body and prevent its spread.

What defines a cavitary lesion in TB patients?

A hollow area in the lung that can contain air-fluid levels.

What is the normal PaO2 level in arterial blood gases?

Typically between 75 to 100 mmHg.

What is the greatest misconception about TB treatment?

That it can be completed quickly; it typically requires several months.

Why might a TB patient's skin test result be negative initially?

If the immune response has not yet developed, especially in the early stages.

What is the therapeutic approach for multidrug-resistant TB (MDR-TB)?

Extensive therapy with multiple antibiotics, often over a longer duration.

What characterizes tuberculosis-related pleural effusion?

Accumulation of fluid in the pleural space due to TB infection.

What compatible lab finding may indicate active TB?

Positive sputum culture for Mycobacterium tuberculosis.