Escolar Documentos
Profissional Documentos
Cultura Documentos
OUTLINE
I. Introduction
A. Millennium
Development
Goals
B. Global
Situation
C. Philippine
Situation
II. Mycobacterium
tuberculosis
III. Transmission
IV. Factors
Affecting
Tuberculosis
V. Symptoms
of
TB
VI. Differential
Diagnoses
VII. Diagnosis
of
TB
Diseases
VIII. Treatment
IX. DOTS
Program
X. WHO
Strategy
XI. QUIZ!!!
I.
I N T R O D U C T I O N
A.
B.
6.
7.
8.
Global Situation
1
2
3
4
5
6
C.
18 July 2011
Pulmonary Tuberculosis
Philippine
Situation
Table
1.
TB
in
the
Philippines
(2007)
Population
in
thousands
87,960
Incidence
of
all
TB*
255
New
sputum
smear*
115
Prevalence
of
all
TB*
36
MDR-TB
Among
new
cases
(%)
4
Among
previously
treated
cases
(%)
21
DOTS
Coverage
(%)
100
Treatment
Success
(%)
88
M y c o b a c t e r i u m t u b e r c u l o s i s
L i a n D e t t e D e n i s e P i a R o n D A r n e l P B G S a n d y P a t s e e T J
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PULMONARY
TUBERCULOSIS
I I I . T R A N S M I S S I O N
IV.
A.
B.
C.
D.
CLINMED
VI.
V I I . D I A G N O S I S O F T B D I S E A S E
F A C T O R S
A F F E C T I N G
T U B E R C U L O S I S
Health-care
Provider
Factors
Failure
to
detect
TB
Apprehensiveness
to
accommodate
TB
patients
due
to
fear
of
acquiring
the
disease
Global
Factors
Massive
migrations
and
convenience
of
travel
Global
Fund
or
NGOs
that
donate
to
TB
programs,
but
theyre
mostly
focused
on
HIV/AIDS
Patient
Factors
Health-seeking
behavior
refusal
to
or
delay
of
consult
Non-compliance
to
treatment
Internal
or
perceived
stigma
patients
are
usually
embarrassed
to
be
treated
for
TB
Societal
Factors
National
Tuberculosis
Program
local
initiative
Lack
of
funds
or
of
information
Overpopulation
Social
stigma
Poor
nutrition
Availability
of
doctors/healthcare
providers
D I F F E R E N T I A L D I A G N O S E S
V.
S Y M P T O M S O F T B
A.
Chest X-ray
TB Diagnostic Committee
Figure
1.
Symptoms
of
TB
Group
6
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PULMONARY
TUBERCULOSIS
B.
CLINMED
Terminology
of
TB
Table
3.
New
and
Old
Terminologies
for
TB
American
Thoracic
Society
(Old)
0
No
TB
exposure
1
TB
exposure,
no
evidence
of
infection
2
TB
infection,
no
evidence
of
disease
3
TB,
clinical
active
B.
Extrapulmonary
(TB
meningitis,
adenitis,
GI)
Smear
(+)
or
(-)
C.
IX.
D O T S P R O G R A M
V I I I . T R E A T M E N T
A.
Group 6
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PULMONARY
TUBERCULOSIS
X.
W H O S T O P T B S T R A T E G Y
XI.
1.
2.
3.
4.
5.
Q U I Z ! ! !
Which
of
the
following
is
false?
A. Humans
are
the
only
known
reservoir
of
M.
tuberculosis
B. Mycobacterium
tuberculosis
is
a
rod-shape,
non-spore
forming,
thick
aerobic
bacteria
C. 0.5
um
x
3
um
in
size
D. Acid-fast
due
to
high
mycolic
acid
and
fatty
acid
content
Which
of
the
following
is
not
a
known
mode
of
TB
transmission?
A. CPR,
mouth-to-mouth
B. Shouting
C. Not
washing
hands
before
cooking
D. Karaoke
Which
of
the
following
is
true?
A. The
most
common
symptom
of
active
TB
is
fever.
B. Chronic
cough
of
at
least
3
weeks
warrants
sputum
AFB
smear,
according
to
the
DOTS
algorithm.
C. A
differential
diagnosis
for
TB
is
malaria,
due
to
night
sweats.
D. The
triad
of
chronic
cough
includes
GERD,
post-nasal
drip,
and
bronchitis.
Which
of
the
following
is
false?
A. Laryngeal
TB
infection
is
one
of
the
most
infectious
states.
B. A
CXR
with
positive
findings
for
TB
does
not
carry
the
same
diagnostic
value
as
an
AFB
smear.
C. Gastric
aspirate
may
be
collected
for
workup
if
there
is
no
sputum
production.
D. Sputum
smear
collection
should
be
done
on
3
alternating
days.
Which
of
the
following
is
true?
A. The
gold
standard
for
treatment
of
latent
TB
is
2HRZE
+
4HR.
B. Tiny
calcific
foci
deposited
in
the
lung
apices
are
called
Simon
foci.
C. Diagnosed
latent
cases
should
be
handed
over
to
a
DOTS
program.
D. A
Mantoux
test
can
be
used
to
diagnose
active
TB
infections.
CLINMED
Properly
interpret
the
tuberculin
test
in
questions
6-10;
answer
with
the
following
choices:
A. Patient
has
TB.
B. Patient
does
not
have
TB.
6. An
HIV-positive
soldier
with
an
induration
of
5mm
and
erythematous
base
of
10mm.
7. A
hospital
microbiology
lab
technician
with
an
induration
of
5mm
and
erythematous
base
of
10mm.
8. A
kidney
transplant
recipient
with
an
induration
of
5mm
and
erythematous
base
of
10mm.
9. A
construction
worker
with
an
induration
of
15mm
and
erythematous
base
of
20mm.
10. An
infant
with
an
induration
of
5mm
and
erythematous
base
of
10mm.
1B,
2C,
3D,
4D,
5B,
6A,
7B,
8A,
9A,
10B
Group
6
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