Tuberculosis D.

Pathophysiology
A. Definition of Related Terms
Tuberculosis (TB – is an infectious
disease that primarily affects the Precipitating Factors: Predisposing
> overcrowded, Factors:
lung. It is primarily a respiratory substandard housing
Inhalation of >Extremes of age
mycobacteriu
disease but can also affect other > performing high
m spp
risk activities as a
organs of the body and is common health worker
among malnourished individuals > institutionalization
> pre-existing
living in crowded area. It is an medical conditions
airborne disease that is > substance abuse
>
transmitted via droplet nuclei – immunocompromised lymph/blood
Transp
particles 1 – 5 µm in diameter status stream kidney
orted
> close contact with to
released through talking, coughing, a TB patient bones
sneezing and singing.
cerebral
alveoli cortex
B. Etiology
Etiologic Agent
Mycobacterium tuberculosis or other inflammation reaction

Mycobacterium spp.
tissue reaction causes accumulation of
Risk Factors exuates
1. Close contact with someone who
has active TB.
2. Immunocompromised Status bronchopnuemonia
3. Substance Abuse
4. Any person who has inadequate
granulomas will be surrounded by macrophages
health care (e.g. the homeless,
impoverished, minorities particularly
children under 15 years of age) calcified:
formation of protective wall collageno
5. Pre-existing medical conditions us
arran scar
6. Immigration from countries with a
transformed to a fibrous tissue ge-
high prevalence of TB (Southeast the center is called Ghons ment or
Asia, Africa, Latin America, focus/tubercle may
beco necrotic:
Caribbean) when there is cheesy
me
decrease in immune mass
7. Institutionalization (long term care system
facilities, psychiatric institutions,
prisons) ulcerates and release
cheesy material to bronchi
8. Living in overcrowded,
substandard housing
9. Being a health worker performing
this causes the infected lung to be
high risk activities. more inflammed
10. Extremes of age

C. Incidence
Globally, there are 9.4 million new
cases of TB in 2008. Although the
total number of new cases of TB is
increased in absolute terms, as a
result of global population, the
number of cases per capita is fading.
The rate of decline is low, at less
than 1% per year. World,
Philippines,

In the Philippines, tuberculosis ranks

sixth in the leading cause of
morbidity and mortality(2002). The
estimated incidence rate of all TB
cases in the Philippines is 243/100
000 population per year (WHO Report
2006). The country ranks ninth
among 22 high burdened countries
under the WHO watch list.
E. Sign and Symptoms
Pulmonary Symptoms:
Dyspnea, Nonproductive or productive cough,
Hemoptysis, Chest Pain that may be pleuritic of
dull, Chest tightness, Crackles may be present on
auscultation
General Symptoms:
Fatigue, Anorexia, Loss of appetite, Low-grade
fever at noon with chills and sweats at night.
F. Diagnostic Exams
Tuberculin Skin Testing- also called the Mantoux
test uses purified protein derivative (PPD) to
identify infection. A small amount (0.1mL) is
administered intradermally to form a 6- to
10-mm wheal. False positive response if
patient has other Mycobacterial infection /
has taken bacillus Calmette –Guerin (BCG).
QuantiFERON-TB Gold Test – is a newer
diagnostic exam that was introduced in
2005.(QFT-G) test is an
enzyme linked
immunosorbent assay (ELISA)
that detects the release of
the interferon –gamma by
white blood cells when the
blood of the patient with
tuberculosis is incubated with
peptides similar in M.
Tuberculosis. It is a blood test used to
identify how a client’s immune system
reacts to M. tuberculosis. A positive result
tells that a person has been infected and
does not confirm if a client has progressed
to the active TB disease.
Acid-Fast Bacillus Smear and Culture -

G. Medical Management
First line Medications

Second line Medicatons

H. Nursing Management
I. Bibliography

Smelter

Black

Cy book