Study Guide on Tuberculosis - M. M. Savula 2002

Prevention
Social prevention

Tuberculosis is more commonly a disease of low-income individuals. In such families, under substandard living and nutritional conditions, coupled with a low cultural level of the patient, children also fall ill more frequently. Therefore, state and social measures aimed at improving living, working, and recreational conditions, ensuring adequate Nutrition, and promoting environmental health are of paramount importance for the prevention of this disease.

To prevent infection among family members, especially children, key provisions include the right of a patient shedding Bacteria to receive an additional isolated living space of 10 m², and the right to undergo Treatment and receive sick leave for 10-12 months. Free specialized sanatorium kindergartens and boarding schools have also been established, where children from families of tuberculosis patients can reside and receive Chemoprophylaxis.

Questions

1. WHAT IS A focus of tuberculosis infection, and what factors determine its level of danger?

2. How often should a visiting nurse visit the most hazardous foci?

3. What anti-epidemic measures must be carried out in a focus of tuberculosis infection?

4. How is concurrent disinfection performed in the focus, and what agents are used for this purpose?

5. How is the patient's sputum disinfected?

6. What health education should the paramedic provide to the tuberculosis patient and their family members?

Case studies

- After revaccinating first-grade students, some BCG vaccine remained in the ampoule. What should be done with the unused vaccine (choose the correct option):

a) store in the refrigerator for use the next day;

b) destroy by boiling;

c) discard the ampoule into a waste container;

d) store under aseptic conditions at room Temperature for use within the next 3 days.

- A child was vaccinated with BCG in the maternity hospital on the 3rd day after birth.

1. At what age should they be revaccinated (choose the correct option):

a) at 12 months;

b) at 3 years;

c) at 5 years;

d) at 7 and 14 years;

e) at 7, 12, and 17 years.

2. How should children be selected for revaccination?

- In a 1.5-month-old child, an ulcer with a diameter of 15 mm formed at the BCG injection site.

1. What does this indicate?

2. What should be your management strategy for the child?

- A child was not vaccinated with the BCG vaccine at the maternity hospital due to contraindications, which have been resolved at 4 months of age.

1. Is the child eligible for vaccination? Under what conditions?

2. If so, where and with which vaccine?

Two months after BCG Vaccination at the maternity hospital, the mother noticed a Lymph node in the child's left axillary region enlarged to 2 cm, which was painless on Palpation. Subsequently, the size of the node increased, and the overlying Skin became cyanotic.

1. Explain the cause of these changes.

2. What should be the feldsher's management strategy for the child?

- A newborn child on the third day of life has a body weight of 2300 g, is in good condition, and has a normal body temperature.

1. Is the child eligible for BCG vaccination, and if so, when?

2. Name the vaccine and its dose if the child is eligible for vaccination.

- A 12-year-old child has a negative Mantoux test. The father has been diagnosed with Infiltrative Pulmonary Tuberculosis in the destruction phase, MTB+.

1. Does the child require additional examination, and if so, what kind?

2. What is the management strategy for the child if no pathological changes are found in the Lungs or other Organs?

- A girl weighing 30 kg has been prescribed chemoprophylaxis due to a "tuberculin conversion".

1. Which antituberculosis drug is typically used for this purpose?

2. Specify its dose for this child and the duration of chemoprophylaxis.

- In your service area, a patient with Fibrocavernous pulmonary tuberculosis, MTB+, lives in a two-room apartment. The family members are his wife and a 20-year-old son.

1. What advice should be given to the patient regarding sputum collection and disinfection?

2. What household items should the patient have for personal use?

3. How often should family members visit a phthisiologist for follow-up examinations?

- A 40-year-old man is newly diagnosed with infiltrative Tuberculosis of the right lung in the destruction phase, MTB+. The family members are his wife and children aged 7 and 12. Develop a plan and sequence of anti-epidemic measures in the focus of tuberculosis infection.

- The family of a patient with Chronic disseminated pulmonary tuberculosis in the destruction phase, MTB+, lives in a two-room apartment. The family members are his wife and a 9-year-old daughter.

1. Which epidemiological hazard group does this focus of tuberculosis infection belong to?

2. How often is a visiting nurse required to visit it to carry out preventive measures?