• 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
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.