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Management and Treatment

- The management and treatment of TB aim to eradicate the infection, prevent transmission, and minimize complications.

- The mainstay of TB treatment is a combination of anti-TB drugs that are taken for at least six months. The most commonly used drugs are isoniazid, rifampin, ethambutol, and pyrazinamide.

- The choice and duration of drug therapy depend on factors such as the type and extent of TB, the drug susceptibility of the bacteria, the patient's adherence, and the presence of co-morbidities.

- Some patients may require longer or more intensive treatment, such as those with multidrug-resistant TB (MDR-TB) or extensively drug-resistant TB (XDR-TB), which are resistant to some or most of the first-line drugs. These patients may need second-line drugs, such as fluoroquinolones, injectable agents, and newer drugs like bedaquiline and delamanid. However, these drugs have more side effects and are less effective than the first-line drugs. Therefore, it is essential to ensure proper diagnosis, drug susceptibility testing, and monitoring of treatment response to optimize outcomes and prevent further resistance.

- The management of TB also involves supportive measures, such as:

  • nutritional supplementation- Patients with TB should be advised to eat a balanced diet that provides adequate calories, protein, vitamins, and minerals to support healing and immune function. They should also drink plenty of fluids to prevent dehydration and help clear secretions.
  • symptom relief- Patients may need analgesics, antipyretics, or anti-inflammatory drugs to relieve pain, fever, or inflammation caused by TB or its treatment.
  • psychosocial support- Patients with TB may experience emotional distress, stigma, isolation, or depression due to their condition. They should be offered counseling, peer support, or referral to mental health services as needed.
  • patient education- Patients should also be educated about the nature, transmission, prevention, and treatment of TB. They should be encouraged to adhere to their medication regimen, report any adverse effects or signs of treatment failure, and complete their course of therapy. They should also be taught how to prevent spreading the infection to others by covering their mouth and nose when coughing or sneezing, disposing of tissues properly, washing their hands frequently, and avoiding close contact with others until they are no longer infectious.

Questions on Management and Treatment

Correct Answer is B

Explanation

Incorrect. TB is not primarily transmitted through contact with skin lesions. It primarily affects the lungs and is transmitted through the respiratory route.

Correct Answer is C

Explanation

Incorrect. Blurred vision and eye pain are not typical symptoms of TB, although TB can affect other parts of the body in addition to the lungs.

Correct Answer is A

Explanation

Incorrect. LTBI does not always progress to active TB disease. In fact, many individuals with LTBI do not develop active disease, but they are at risk, especially if their immune system becomes compromised.

Correct Answer is A

Explanation

Incorrect. Avoiding close contact with the client is not a practical measure for healthcare professionals providing care to TB patients. Proper isolation measures are more effective.

Correct Answer is A

Explanation

Incorrect. Although improving patient compliance is important, the primary purpose of using multiple drugs is to reduce drug resistance.QUESTIONS

Correct Answer is C

Explanation

Incorrect. While cleanliness and hygiene are important, excessive handwashing alone is not sufficient to prevent TB transmission, as the bacteria are primarily transmitted through the air.

Correct Answer is A

Explanation

Incorrect. TB bacteria in latent infection are in a dormant state and do not actively multiply, although they remain viable.

Correct Answer is A

Explanation

Incorrect. Although improving patient compliance is important, the primary purpose of using multiple drugs is to reduce drug resistance.

Correct Answer is C

Explanation

Incorrect. LTBI carries a risk of progressing to active TB disease, although the risk is relatively low in many individuals.

Correct Answer is A

Explanation

Incorrect. Granulomas are not the primary site of TB bacteria replication; instead, they are formed to limit bacterial replication and spread.

Correct Answer is C

Explanation

Incorrect. Underlying health conditions like HIV, diabetes, and immunosuppression can indeed increase the risk of TB due to compromised immune function.

Correct Answer is C

Explanation

Incorrect. LTBI and active TB disease are distinct conditions, and LTBI does not always require immediate treatment. Treatment may be recommended for individuals at higher risk of progression to active disease.

Correct Answer is B

Explanation

Incorrect. While using multiple antibiotics can help manage side effects, the primary reason is to prevent drug resistance.

Correct Answer is D

Explanation

Correct. Following good respiratory hygiene and avoiding crowded, poorly ventilated areas are essential measures to reduce the risk of TB transmission in high-burden areas.

Correct Answer is D

Explanation

Correct. Completing the recommended treatment course for LTBI is essential to reduce the risk of developing active TB disease.

Correct Answer is C

Explanation

Incorrect. Confusion and memory loss are not typical symptoms of pulmonary TB; they may occur in cases of disseminated or extrapulmonary TB.

Correct Answer is B

Explanation

Incorrect. Atypical pneumonia may have different symptoms, and it is not the most likely diagnosis based on the symptoms provided.

Correct Answer is D

Explanation

Correct. Coughing up blood (hemoptysis) is a possible symptom of TB and should be reported to a healthcare provider for further assessment and management.

Incorrect. Cervical lymphadenopathy is not necessarily indicative of a secondary bacterial infection.

Incorrect. While anxiety or panic attacks can cause chest discomfort, pleuritic chest pain is more likely related to a physical condition, such as pleural inflammation.

Incorrect. CT scans may be used in TB diagnosis but are not typically used for initial screening of TB infection.

Incorrect. Gram stain is a laboratory technique used to visualize the characteristics of bacterial cells but is not specific for Mycobacterium tuberculosis.

Incorrect. Chest X-rays are routinely used in the diagnosis and management of TB, especially for assessing lung involvement.

Incorrect. Sputum samples should be collected in specific containers designed for this purpose to maintain sample integrity and avoid contamination.

Incorrect. CT scans are commonly used in the evaluation and management of TB, especially for assessing lung abnormalities.

Incorrect. Medications for TB should not be shared with family members or others, as they need individualized treatment and evaluation.

Correct. Using multiple medications in combination therapy makes it more difficult for TB bacteria to develop resistance to all drugs simultaneously, helping to prevent drug-resistant TB.

Incorrect. Waiting until the next appointment may lead to prolonged side effects and potential treatment complications.

Incorrect. TB treatment should be completed as prescribed, regardless of the absence of symptoms, to prevent drug resistance and relapse.

Incorrect. TB can be transmitted in close household settings, so infection control measures are important to prevent transmission to family members.

Incorrect. TB medications should be taken as prescribed, not solely based on symptom severity.

Incorrect. Isolation is not typically needed during TB treatment, as clients can resume their normal activities once their infectiousness has decreased.

Incorrect. Ventilating living spaces by keeping windows and doors open, not closed, helps reduce the concentration of infectious particles in the air.

Incorrect. While treatment duration can vary based on individual factors, the minimum duration is typically six months for active TB.

Incorrect. Follow-up appointments are typically not optional; they are a standard part of TB care to ensure successful treatment and minimize the risk of relapse.
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