Tuberculosis

1. Lab and Diagnostics

1.1. TB skin test

1.2. Chest radiograph study

1.3. Bacteriological studies (sputum cultures)

1.4. Drug therapy

1.5. History and physical examination

2. Risk Factors

2.1. Low socioeconomic status

2.2. Cigarette smoking

2.3. Alcohol and substance abuse

2.4. Physical environment (overcrowding and homelessness)

2.5. Culture (first nations, immigrants)

3. Clinical Manifestations

3.1. Fatigue

3.2. Malaise

3.3. Anorexia, weight loss

3.4. Low grade fever

3.5. Night sweats

3.6. Cough

3.7. Mucopurulent sputum

3.8. Dull or tight chest pain

4. Complications

4.1. Miliary TB (invades blood stream)

4.2. Pleural Effusion and Empyema (triggers inflammatory reaction and exudate)

4.3. TB pneumonia

4.4. Other organ involvement (kidneys, adrenals, meninges, lymph nodes etc. are infected)

5. Medications

5.1. Isoniazid (bactericidal, interferes with DNA metabolism)

5.2. Rifampin (Rifadin, Rimactane) (bactericidal, inhibits RNA polymerase)

5.3. Ethambutol (Myambutol) (bactericidal, inhibits RNA synthesis)

5.4. Pyrazinamide (bactericidal)

5.5. If you have a drug-resistant TB, a combination of antibiotics called fluroquinolones and injectable medications, such as amikacin and kanamycin or capreomycin are generally used for 20 to 30 months

5.6. Completing treatment is essential

6. Collaborative Interventions

6.1. Long term treatment with antibiotics

6.2. Follow-up bacteriological studies

6.3. Chest radio exams

6.4. Most patients are treated in out-patient

6.5. Main focus of treatment is drug therapy

7. Health Teaching

7.1. Encourage vigilance and awareness of normal sign and symptoms

7.2. Cannot get TB by sharing drinks, toys or personal items

7.3. People at greater risk; those living with someone who has TB, those who had TB but did not complete treatment, elderly people, immunocompromised people

7.4. All TB patients should be tested for HIV, included suspects, patients and contacts

7.5. Someone with TB infection and HIV infection has a very high risk of developing TB disease

7.6. Important for patient to remain on isolation at home

8. definition: an infectious disease caused by M. tubercullosis. Involves lungs, kidneys, bones, adrenal glands, and meninges; small droplet..need neg airflow room; Factors that influence transmission are: number of organisms in the air, concentration ie small spaces, length of exposure, and immune system of pt