Download MBBS Pulmonary Medicine Presentations 7 Tuberculosis Integrated Lecture Notes

Download MBBS (Bachelor of Medicine, Bachelor of Surgery) 1st Year, 2nd Year, 3rd Year and Final year Pulmonary Medicine 7 Tuberculosis Integrated PPT-Powerpoint Presentations and lecture notes


Clinical Manifestations &

Overview of Management of

Pulmonary Tuberculosis

Dept of Pulmonary Medicine

Learning Objectives

? When to suspect Pulmonary Tuberculosis?

? How to diagnose?

? How to manage a case of drug susceptible Tuberculosis?
When to suspect?(Pulmonary)

? TB suspect Presumptive Tb

? > 2weeks cough

? fever>2 wks,

Dyspnea

? significant wt loss

Chest pain

? Haemoptysis

? abnormal CXR

Signs

? General

? Emaciated
? Pal or

? Cyanosis

? Clubbing

? Edema

? LNpathy




? Respiratory

? Any

? Consolidation

? Fibrosis

? Cavity

? Pleural inv

? Miliary



Signs

? Bronchial

? Dec/Absent BS

? Normal

? Added sounds

Diagnostic tools


Diagnostics

? CXR: ? Sensitivity & poor specificity

? Complementary tool

? Microscopy:

? Serology:Banned

? Gold standard:culture

? LJ media

? Rapid :Bactec

? MGIT

? Bac T


Diagnosis

? Microscopy

? ZN stain

Phenotypic methods

Phenotypic methods

? Flourescent

? Culture

? solid (6-8 wks)

? liquid (42 days)

? Rapid

Genotypic methods

? CBNAAT

? LPA
OLD


RNTCP 2017

Management

? Medical:

? long duration

? IP & CP

? Surgery:complications

? Haemoptysis

? Aspergilloma

? Pleural diseases
TREATMENT REGIMENS

Type of TB case

Intensive Phase

Continuation Phase

New

2RHEZ

4RHE

Retreatment

2SIH

nt REZ

ermi /

tt1R

en H

t EZ

regimens 5RHE

are being changed to

daily regimens under

RNTCP in India

R;rifampicin,H:isoniazid,E:ethambutal,Z:pyrazinamide,S:streptomyci

n

? CAT 1 & 2

? CAT 4 :MDR

? CAT 5:XDR

? Definitions

? MDR:R and H

? XDR:R and H,any FQ,any injectables(kanamycin,amikacin,capreomycin)

? Primary & acquired resistance

? Mono/poly drug resistance:DRTB
DR TB:Principles of Treatment

? MDR:4 second line drugs /not used

? XDR:7 drugs

? Duration:24(MDR),36(XDR)



DOTS plus previously

Second line drugs

? Treatment longer
? Toxic
? Expensive

more

? Stress:emergence rather than treatment of DRTb
Infection Vs Disease

? What `s the difference

? For Infection

? Mantoux/PPD

? Interferon gamma release Assay

? TB Gold/Elispot
COMPLICATIONS

? Local-?ARDS/respiratory failure

? Bronchiectasis/PTOAD

? aspergilloma

? haemoptysis (symp )

? Pleural -Empyema/pneumo

? Extensive lung destruction

? Rt middle lobe syndrome

? Scar ca

? Systemic-

? shock

? amyloidosis

? disseminated tb-(laryngeal tb)

? Cor-pulmonale
THANK YOU

This post was last modified on 08 April 2022