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WORK UPS AND MANAGEMENT

WORK UPS AND MANAGEMENT. Traditional and New Diagnostic Approaches. Traditional and New Diagnostic Approaches. Diagnosis of TB. A positive culture with or without a positive smear for M. Tuberculosis is the gold standard for the diagnosis of TB

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WORK UPS AND MANAGEMENT

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  1. WORK UPS AND MANAGEMENT

  2. Traditional and New Diagnostic Approaches

  3. Traditional and New Diagnostic Approaches

  4. Diagnosis of TB • A positive culture with or without a positive smear for M. Tuberculosis is the gold standard for the diagnosis of TB In the absence of bacteriologic evidence , a child is presumed to have active TB if > 3 crteria are present: • Exposure to an adult/Adolescence with active TB (EPIDEMIOLOGIC) • Signs and symptoms suggestive of TB (CLINICAL) • Positive tuberculin test (IMMUNOLOGIC) • Abnormal chest radiograph suggestive of TB (RADIOLOGIC) • Other lab findings suggestive of TB (LABORATORY)

  5. OUR PATIENT • TST – 12 mm induration • Chest X –ray showed evidence of primary infection • Signs and symptoms of TB

  6. Chest X- ray of the patient 11/24/10

  7. The heart is not enlarged. There is slight haziness over the right lung base and the retrocardiac region, with nodular densities over the retrocardiac region, which may be due to lymph nodes. This may represent primary infection. Both hemidiaphragm and sinuses are normal. The visualized osseous structures are unremarkable. 11/24/2010

  8. Management of Tuberculosis

  9. Objectives of Drug Therapy in TB: • Cure the patient of TB • Prevent death from active TB • Prevent relapse of TB • Prevent the development of drug resistance • Decrease transmission

  10. Phases of Treatment • Intensive Phase - efficient killing of actively dividing organisms - relief of symptoms - terminates transmision - prevents emergence of drug resistance • Continuation Phase - kills irregularly dividing bacilli - sterilizes lesions and prevent relapse

  11. Drug Administartion • The optimal dosing frequency for new patients with pulmonary TB is daily throughout the course of therapy. Alternative Regimens: • A daily intensive phase followed by tree times weekly continuation phase [2HRZE/4H3R3] , provided that each dose is directly observed • Three times weekly dosing throughout the therapy [2H3R3Z3E3/4H3R3] , provided that every dose is directly observed.

  12. Essential Anti-Tuberculosis Drugs

  13. Essential Anti-Tuberculosis Drugs

  14. Essential Anti-Tuberculosis Drugs

  15. Essential Anti-Tuberculosis Drugs

  16. TREATMENT 21 kg Isoniazid 200 mg/5mL (10 mkd) – 5.5 mL Rifampicin 200mg/5mL (10 mkd)- 5.5 mL Pyrazinamide 500 mg/5mL (20 mkd) – 4.5 mL Ethambutol 400 mg/tab (20 mkd) - 1 tab

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