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Tuberculosis in Infancy and Childhood > CPM 7th Edition > Flashcards

Flashcards in CPM 7th Edition Deck (45):
1

Incubation period of TB refers to the time the tubercle bacilli enter the body until

Tissue hypersensitivity develops, ie (+) TST

2

Incubation period of TB

19-56 days or 3-8 weeks

3

Ghon focus is usually located in

Subpleural area of the upper segment of the lower lobe or in the lower segment of the upper lobes

4

Tissues that favor retention and bacillary multiplication

apical posterior areas of the lung, LN, kidneys, vertebral bodies, epiphysis of long bones

5

Timetable that describes the usual early course and timing of the initial Tb infection and its common complications

Wallgren's timetable

6

Based on Wallgren's timetable, complications from TB are especially expected to occur when

First year

7

TB lesions involving bones and joints seen in 5-10% of infected children do not appear until ___

At least a year after initial infection

8

TB lesions involving the kidneys do not appear until ___

15-25 years after initial infection

9

Symptomatic, massive lymphohematogenous spread of TB, ie miliary or acute meningeal Tb is rare and seen in only ___% of affected children

0.5-3%

10

Symptomatic, massive lymphohematogenous spread of TB, ie military or acute meningeal Tb usually occurs ___ after initial infection

2-6 months

11

Criteria for TB exposure or Class I

Exposure to an adolescent/adult with active TB

12

Criteria for TB infection or Class II

1) ± history of exposure 2) (+) TST

13

Highest risk of developing TB is seen in infants, developing in up to ___% of infants within 3-9 months of infection

50%

14

Risk of developing TB is ___% in CHILDREN 1-5 years of age within 1-2 years

25%

15

Risk of developing TB is ___% in adolescents

15%

16

Criteria for TB disease or Class III

3 or more of the ff: 1) Exposure 2) (+) TST 3) Signs and symptoms suggestive of TB (at least 1) 4) (+) CXR 5) (+) Lab findings

17

Signs and symptoms suggestive of TB

1) Cough/wheezing >2 weeks; fever >2 weeks 2) PAINLESS lymphadenopathy 3) Poor weight gain; failure to make a quick return to normal

18

Who should be investigated for miliary TB

Infants or children <2 years of age who present with fever, cough, pallor, weight loss, with or without hepatomegaly/splenomegaly

19

Criteria for TB inactive or Class IV

1) ± previous chemotherapy 2) + radiographic evidence of healed/calcified TB 3) + TST 3) No signs or symptoms suggestive of TB 4) Smear/culture for M. tb negative

20

T/F: The younger the patient, the greater the risk of progressive TB disease

T

21

T/F: In TB disease, young infants and adolescents are more likely to have significant signs and symptoms than school-aged children

T

22

T/F TB pleurisy with effusion is an early complication of primary infections

T

23

Lung lobe that is most vulnerable when there is enlargement of the hilar LN

Right middle lobe followed by the right upper lobe

24

Miliary tb which results from

Discharge of a caseous focus into the blood vessel

25

Type of TB infection seen in a host previously sensitized by earlier Tb infection, characterized by apical or infraclavicular infiltrates often with cavitation and NO hilar lympadenopathy

Chronic PTb

26

T/F Tuberculomas are a common condition, affecting a significant number of untreated TB infections in children

F, only 0.4%

27

T/F Pericardial Tb is a common condition

F

28

T/F Enlarged cervical LN in Filipino children are more often caused by infections other than TB

T

29

MC Tb of the CNS

TB meningitis

30

TB meningitis complicates ___% of untreated Tb infections

0.3%

31

MCC of mortality from TB below age 3 years

TB meningitis

32

TB meningitis is frequently seen in what age group

First 6 years of life

33

TB meningitis is rare in what age group

First 4 months

34

TB meningitis accompanies military Tb in approx ___% of cases

50

35

Cranial nerves involved in CNS Tb

III, VI, VII, and optic chiasm

36

A negative TST rules out TB meningitis

F

37

Tuberculoma vs Abscess: More common in CNS Tb

Tuberculoma

38

Tuberculoma occur most often in children of what age

Less than 10 y/o

39

Tuberculomas are most often located at

Base of brain around the cerebellum

40

Tb of bone and joints are more common in younger vs older children

Younger, due to increased blood flow in growing bones

41

Tb of bone: Multiple vs single vertebral body

Multiple

42

Next to spine, these joints appear to be susceptible to implantation and proliferation of Tb bacilli

Hips, knees, and ankles

43

Tb of skin overlying a caseous LN that has ruptured to the outside, leaving an ulcer or a sinus

Scrofuloderma

44

Ocular Tb is uncommon in children, but when present, frequently involves

Conjunctiva and cornea

45

MC ocular manifestation in patients with systemic Tb

Choroiditis