Extrapulmonary TB #1
pelvis, femur, and tibia
10% of skeletal TB is at which site?
cervical
25% of skeletal TB is at which site?
lumbar
25% of skeletal TB is at which site?
thoracolumbar spine
50% of skeletal TB is at which site?
3 million people annually
TB kills how many people annually...
south Africa, north korea, congo, bangledesh, Pakistan, Philippines, Nigeria, afghanistan
TB rates by country, from highest to lowest.. (Nigeria, Philippines, Afghanistan, south Africa, congo, Pakistan, bangledesh, north korea)
infected droplets
TB spread by..
air, lungs
TB travels through what? What part of the body does TB enter first?
cold abscesses
are scrofula neck masses cold or hot abscesses?
"phthisis"
common illness more than 2000 years ago in ancient Greece. believed to be the same disease we now call TB.
no
does TB always cause disease in the lungs?
consumption, white plague
during first half of 20th century, TB was called..
1.4 million
how many TB deaths occurred in 2010?
4000 cases
how many cases of extrapulmonary TB/yr in the US?
9 cases
how many cases were found in Dona Ana county for 2009?
48 cases
how many cases were found in NM in 2009?
11,182, 3.1 percent
how many cases were reported in the US for 2010? what percentage of decline is this compared to 2009?
stain red
how will TB bacilli stain with acid fast stain test?
9 million people
in 2010, how many people around the world become sick with TB?
50 percent
in some countries what percent of the population are infected with TB?
infected milk from dairy cattle
in some parts of the world TB is transmitted by...
not useful
is skin testing useful where BCG vaccination is widely used?
not useful
is skin testing useful with immunocompromised persons?
not useful
is skin testing useful with persons newly infected with TB, or in persons with miliary TB?
mycrobacterium tuberculosis organism
organism that causes TB
TB infection
what TB bacteria is alive but inactive in the body?
miliary TB
what TB disease has spread to the whole body through the bloodstream
BCG
what TB vaccine is named for the French scientist Calmette and Guerin.
2/3
what amount of patients will have abnormal chest x-rays with extrapulmonary TB?
1/3
what amount of the world's population is infected with TB?
resistant to the 5 main drugs
what are TB bacteria stains becoming?
Caseous necrosis in TB
what are a type of TB lesions mean "cheesy?"
an increase
what did neglect, AIDS virus, drug resistant bacteria, poverty, homelessness, drug abuse, immigration, international travel, cause with TB?
dismantled public health infrastructure
what did the fed government do because they thought TB was gone?
patients quit taking TB drugs
what do patients do that allows bacteria that are resistant to the TB drugs to multiply and become dominant?
directly observed therapy - short term
what does DOTS stand for?
small red rods
what does TB bacilli appear as on acid fast stain tests?
positive test
what does an area of induration (not redness greater than 10mm) mean on a skin test?
TB lesions
what does miliary TB cause?
expose others to the disease
what happens when infected people travel?
mycobacterium tuberculosis
what has a waxy coating that protects it. it requires oxygen, which is why it prefers the respiratory tract, and internal organs and the skeleton are involved by blood borne infection?
TB disease
what illness has TB bacteria that are multiplying and attacking different parts of the body?
DOTS
what is a healthcare regimen in which health workers directly observe the patient taking their medications for the entire course of treatment?
goiter
what is an enlarged scrofula mass around the neck/thyroid area called?
extensive necrosis and bony destruction, and compression fractures
what is caused by skeletal TB?
spine
what is the most common location of extrapulmonary TB?
lungs, upper lobes of either lung
what is the most common site of TB infection? what part of the lung is initially damaged?
severe kyphosis, sinus formation, and Pott's paraplegia
what is the sequelae (outcome) of skeletal TB?
skeletal TB
what type of TB can have a moth-eaten appearance?
active TB disease
what type of TB disease: bad cough (more than 2 weeks), chest pain, coughing up blood or sputum, weakness/fatigue, no appetite, chills, fever, sweating at night, may spread TB to others, positive skin test, abnormal chest x-ray?
latent TB infection
what type of TB infection: patient does not feel sick, cannot spread TB to others, positive skin test, chest x-ray and sputum test normal?
CNS TB
what type of TB is a meningeal pattern of spread that can occur. the base of the brain is often involved - various cranial nerve signs may be present. solitary "tuberculoma" may cause seizures.
extrapulmonary TB
what type of TB is in any part of the body other than the lungs?
urinary tract TB
what type of TB is progressive destruction of renal parenchyma if not treated. drainage to ureters can lead to inflammation with ureteral stricture.
genital tract TB
what type of TB is tuberculosis that involves the prostate and epididymis most often w/non-tender induration and infertility?
skeletal TB
what type of TB is tuberculous osteomyelitis involves mostly the t-spine and l-spine, followed by the hip and knee.
genital tract TB
what type of TB is tuberculous salpingitis and endometritis (irregular menstrual bleeding and infertility)?
extrapulmonary TB
what type of TB occurs outside the lungs?
skin testing
what type of TB testing is useful where incidence of TB is low and in healthcare systems?
multiple drug resistant TB
what type of TB treatment requires 2-4 drugs to be taken for 6-12 months?
Scrofula
what type of TB: neck masses. often they will rupture and drain. surgery is not advised. medication is the treatment of choice.
GI TB
what type of TB: pasteurization of milk has greatly decreased the incidence. a diagnosis of Crohn's disease in persons from 3rd world countries is always this type of TB. presents as circumferential ulcerations with stricture of the small intestine. ieocecal involvement is common.
Scrofula
what type of TB: tubuculous lymphadenitis of the cervical lymph nodes - form a mass of firm, matted nodes under the mandible with chronic drainage to overlying skin via fistula tracts.
eradicated from the US
what was thought of TB in 1985?
india and italy
where do TDR (totally drug resistant) and XXDR (extremely drug resistant) TB exist?
lymph nodes, blood stream
where may TB germs move to? How do they move through the body?
small infants and small children
who is BCG given to (where TB is very common)?
compromised immune system
why are people with HIV/AIDS more susceptible to getting TB?
high HIV, MDR, and TB burden
why are rates so high in some countries?
skeletal TB
widened pre-vertebral soft tissue, subluxation, and partial destruction of vertebral bodies at several levels are all signs of what type of TB?
