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What is tuberculosis disease caused by?
mycobacterium tuberculosis, tubercle bacillus or acid-fast bacillus
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What percent of americans may have TB infection and may not know it?
4-6%
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T or F: T.B. can be inactive but can become active at any time?
true
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What can the infection be treated with and how long?
isoniazid and 6-12 months
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If taking the medicine the risk of it becoming active reduces by ____%?
90
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How much percent will active TB will die from the disease?
5-10%
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What can TB affect in the body?
lungs, larynx, spine and kidneys
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What destroys tissue, replacing it with fibrous connective tissue?
bacteria
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What does symptoms include for TB?
fatigue, weight loss, fever, chills and night sweats
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What are the symptoms of TB of the lungs?
persistent cough, chest pain, coughing up blood (hemoptysis)
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How is TB infection diagnosed?
Mantoux skin test (PPD)
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How is mantoux skin test injected?
is injected into the layers of the skin termed an "intradermal" injection
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What is PPD?
purified protein derived tubercle bacilli
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How long after the shot can the test site be examined for a positive examination?
48-72 hours
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What is present if there is evidence of infection?
5mm hardened area
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Who can have false negatives due to their compromised immune systems?
HIV
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What is the most common screening method for TB?
mantoux tuberculin skin test
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What other test can be done instead of mantoux tb skin test?
- chest x-rays
- sputum smears
- sputum cultures
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TB is spread by __________?
airborne transmission
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What travels by minute droplets (droplet nuclei transmission)?
tubercle bacilli
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What is transmitted by inhalation of contaminated air?
droplet nuclei
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What actions can spread TB?
sneezing, coughing, singing, talking, shouting, or breathing
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What collects around the TB bacilli?
inflammatory cells
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inflammatory cells collect around a clump of TB bacilli to form a small mass called a ______?
tubercle
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These scars are most often found in the ________?
apex of the lungs (top)
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What does often contain which is deposited as healing occurs?
calcium
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What does necrotic mean?
dead essentially
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If resistance is poor or the infection dose large, the bacilli kill the inflammatory cells, and the center of the mass becomes?
necrotic
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What is hemoptysis?
coughing up blood
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Reactivation of TB from dormant tubercles is termed?
secondary TB
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What are high risk groups?
the homeless, elderly, prison inmates, alcoholics, IV drug users, persons with HIV infections/AIDS, children living with these people
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What are high risk groups?
African Americans, Asians, American Indians, Hispanics, Foreign born: asia, Africa, Caribbean, latin america
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Non whites have __X higher rate of TB incidence?
11
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Who are at the lowest risk of TB?
5-14 year old children
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Who is at high risk due to their immature immune systems?
infants
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How many new cases per year are there of TB?
approximately 30,000
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What percent of people with inactive disease will become active and become infectious?
10%
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How many people in the U.S. have an inactive TB infection?
10-15 million
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What is it called when recent strains of TB have become resistant to the drugs which are treat the disease?
multi-drug resistant TB
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What type of TB is very difficult to treat because it doesn't respond to the drugs typically used to treat the disease?
multi-drug resistant TB
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What are the causes of multi-drug resistant TB?
- medication is not taken as directed
- medication must be taken 6-9 months to 2 years
- patients feel better and stop taking meds
- medications cause unpleasant side effects such as nausea
- high risk patients may not be able to afford medication
- high risk patients are often transient
- medications are sometimes prescribed incorrectly
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What are adverse reactions with rifabuten?
arthralgia, arthritis, uveitis, and gastrointestinal
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What are adverse reactions with ethambutol?
neuropathy, causes defect in red-green vision
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What can be done to stop the increase in multi-drug resistant TB?
- patient education
- directly observed therapy
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What are methods of prevention?
the patient should cover his/her mouth with tissues when coughing, isolation of patient, proper ventilation of facility, UV light fixtures, HEPA filters
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What kind of isolation is there for TB patients?
- respiratory isolation
- AFB-(acid fast bacillus) isolation
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How often should healthcare personnel be screened using skin tests?
annually
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How often should healthcare personnel be screened in a high risk setting?
every 6 months
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The CDC recommends what action plan to prevent the spread of TB disease?
- screening of patients at high risk of TB
- rapid diagnosis
- appropriate therapy
- reducing air contamination
- providing isolation rooms
- screening healthcare personnel
- investigating and controlling outbreaks
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Why doesn't surgical masks help prevent TB?
because it does not allow a seal around your mouth and nose
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How small are TB particles?
1 to 5 microns smaller than dust particles
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