• DDx for Upper Lobe Cavitary Lesions:
  • Think TB and Sarcoid (Usually patients with Sarcoid have prominent disease on radiography but clinically look well)
  
  Silicosis - can see upper lobe disease, predominantly see eggshell calcifications around lymph nodes.
  
  

  Posted 11/17/16 11:22:28 AM by Adam Faye

• • Laryngeal TB- Most infectious form of TB
  • Smoking makes it:
    • more likely latent TB --> active TB
    • harder to treat
    • more likely to relapse
  • TB can cause SIADH as well (typically we think of SIADH from Small Cell Lung Ca)
  
  

  Posted 11/17/16 11:30:37 AM by Adam Faye

• TB Diagnosis:
  • Smear has ~50-65% sensitivity; typically need 100,000 organisms to be positive.
  • GeneXpert- detects DNA, also tests genetic mutations a/w rifampin resistance - higher sensitivity and can detect with only 150 organisms.
  • Induced sputum can be as good as bronchoscopy in obtaining a sample.
  
  

  Posted 11/17/16 11:36:30 AM by Adam Faye

• TB Infectivity:
  • 100% non-infectious only when the Culture becomes negative.
  • Once under going treatment, time to positive growth of culture should lengthen.
  • Cavitary lesions and more organisms on smear lead to longer periods of time until Cultures clear.
  
  

  Posted 11/17/16 12:12:48 PM by Adam Faye

• Drug Sensitive TB - Do NOT need to give Ethambutol 
  
  

  Posted 11/17/16 04:59:20 PM by Adam Faye

Created by Christopher Kelly

Know a hypochondriac? Get them the best-selling book 'AM I DYING?!: A Complete Guide to Your Symptoms, and What to Do Next'
The information on the website does not constitute official guidelines except where explicitly stated.
It is not meant to replace the advice of a health professional.