Tuberculosis Study Guide - M.M. Savula 2002

Answers to the problems

Topic 5. Diagnostic Methods for Tuberculosis

1. It is not allowed.

2. Complete Blood count and urinalysis, sputum smear Cell/15.html">Microscopy for MTB, chest fluorography or chest X-ray.

1. Sputum smear microscopy for MTB.

2. In the morning on an empty Stomach, after rinsing the Mouth, collect sputum into a boiled and dried jar with a lid and deliver it to the laboratory. If the sputum cannot be delivered within 2 hours, add an equal volume of 2% boric acid solution to it.

After 3 weeks.

Topic 5.6. Tuberculin Diagnostics

> d).

> 1. Yes, it is permitted.

2. On the right forearm.

> 1. Post-vaccination.

2. Not required.

> 1. Infectious.

2. Refer to a phthisiatrist.

> 3 children with a newly positive reaction and a papule diameter of 5-7 mm; 2 children with a newly positive reaction and a papule diameter of 18 mm.

Topic 7. Primary tuberculosis in children

> 1. a) About possible contact with a TB patient, history of past illnesses.

b) Nutritional status of the child, presence of 2 post-vaccination scars on the left upper arm, Palpation of peripheral Lymph Nodes, Percussion and Auscultation of the chest.

2. To a phthisiatrist (pediatric phthisiatrist).

3. Dates of BCG Vaccination, current and previous Mantoux test results.

> 1. Possible.

2. Refer to a phthisiatrist (pediatric phthisiatrist).

3. Medical history, physical examination, palpation, percussion, auscultation, complete blood count and urinalysis, chest X-ray.

> Tuberculosis intoxication.

Topic 10.6. TUBERCULOSIS OF PERIPHERAL LYMPH NODES

> 1. Patient B.

2. Mantoux test with 2 TU, chest radiography, and lymph node biopsy if necessary.

Topic 11. Tuberculosis and Pregnancy

> 1. Yes.

2. No.

3. Hospitalize the woman in a TB dispensary, and have the child stay with healthy relatives or place them in a children's home.

> 1. No.

2. Treat.

Topic 12.2. Chemotherapy

> 1. Adverse reaction to streptomycin.

2. Discontinue this medication and refer the patient for a consultation with a phthisiatrician.

> 1. Adverse reaction to isoniazid.

2. Vitamins B₆, B₁.

3. Discontinue isoniazid and refer the patient for a consultation with a phthisiatrician.

Topic 13. Complications of tuberculosis

> Ascorutin tablets 0.5 g or ascorbic acid tablets 0.1 g, Vikasol 1% ampoules 1 ml, etamsylate tablets 0.25 g or 12.5% ampoules 2 ml, calcium chloride or calcium gluconate 10% solution in 10 ml ampoules, aminocaproic acid powder 2 g, papaverine 2% solution in 2 ml ampoules, euphylline 2.4% solution in 10 ml ampoules.

> 1. b) Spontaneous pneumothorax.

2. Assist the patient into a semi-seated position; in case of severe pain, administer analgin 50% - 2 ml intramuscularly and immediately call an emergency medical team. If Heart Failure progresses, administer corglycon 0.06% - 1 ml in 0.9% sodium chloride solution slowly intravenously.

> 1. a) Chronic Cor Pulmonale, decompensation.

б) In case emergency hospitalization is not possible, administer Diuretics (furosemide - 0.04 g orally or 1% solution 2 ml intramuscularly), corglycon 0.06%-1 ml or digoxin 0.025%-0.5 ml in 0.9% sodium chloride solution slowly intravenously.

в) To a tuberculosis hospital.

Topic 14. DETECTION OF TUBERCULOSIS

> 1. a); c).

2. Once a year.

> 1. Late

2. Yes (PEPTIC ULCER DISEASE).

3. Fluorography should be performed once a year.

> 1. c); d); e), je).

2. Once a year.

> 1. Bronchitis, tuberculosis, Lung Cancer.

2. Medical history taking, physical examination, complete blood count, urinalysis, fluorography, and sputum smear microscopy for MBT.

Topic 15. PREVENTION

> b).

> 1. d).

2. Conduct a Mantoux test with 2 TU beforehand.

> 1. Complications of the BCG vaccination.

2. Refer to a phthisiatrician.

> 1. Yes, after performing the Mantoux test, provided the result is negative. 2. At the children's polyclinic using the BCG-M vaccine.

> 1. Complications of the BCG vaccination.

2. Refer to a phthisiatrician.

> 1. Yes, it is required, on the third day after birth.

2. BCG-M vaccine.

> 1. General blood and urine tests, chest X-ray.

2. Administer Chemoprophylaxis with isoniazid (prescribed by a phthisiatrician).

> 1. Isoniazid.

2. Dose: 0.2 g daily for 3 months.

> 1. Collect in an individual pocket sputum cup; for disinfection, place in an enameled container and boil for 15 minutes in a 2% soda solution.

2. Bed linen, towels, tableware.

3. Once every 6 months.

> Hospitalization of the patient, final disinfection of the premises, and examination of all family members by a phthisiatrician.

> 1. To the first group.

2. Monthly.

Topic 16 Organization OF ANTI-TUBERCULOSIS CARE AND DISPENSARY FOLLOW-UP

> 1. To group 1.

2 . Monthly.

3. To group IV.

4. Once every 6 months.

TOPICS RECOMMENDED FOR INDEPENDENT STUDY

5.2. X-RAY DIAGNOSTICS.

5.3. Ultrasound examination.

5.5. Instrumental methods of INVESTIGATION.

6. Clinical Classification of Tuberculosis.

9.4. Pulmonary Tuberculoma.

9.6. Cirrhotic Pulmonary Tuberculosis.

9.8. RESPIRATORY TUBERCULOSIS COMBINED WITH OCCUPATIONAL DUST-INDUCED LUNG DISEASES (CONIOTUBERCULOSIS).

10.5. TUBERCULOSIS OF MESENTERIC LYMPH NODES (MESADENITIS).

12.2. NON-SPECIFIC THERAPEUTIC METHODS.

12.3. Surgical Treatment.

15.4. Social prevention.

16. ORGANIZATION OF ANTI-TUBERCULOSIS CARE, DISPENSARY FOLLOW-UP.

17. ANTI-TUBERCULOSIS ACTIVITIES CARRIED OUT BY FELDSHER-MIDWIFE STATION (FMS) PERSONNEL.