Question

What diagnostic testing will the Provider order to confirm a diagnosis of TB?

What Isolation precautions do you expect to be put in place and why?

Describe the recommended treatment regimen for TB, including the rationale for combination drug therapy.

Identify the reason compliance to medication therapy is often a concern in the patient with TB.

What should be done for Wilson's 6 roommates?

Answer 1

Ans 1: TB: TB is an abbreviation Tuberculosis.

Diagnostic Testing Procedure: The symptoms of TB is very similar to many diseases. So it is quite difficult to diagnose by their own.This disease is caused by a bacterium called as Mycobacterium tuberculosis. This disease spreads from person to person through microscopic droplets released into the air.There are so many tests which helps to identify this bacterial infection. Some times symptoms of this disease may not appear.

Basic test: In which Doctors ask about the medical history of the patient and check any kind of symptoms by physical analysis like to listening the sound of lungs and check the swelling of lymph nodes.

To check the presence of bacteria two test will be recommended by Specialists:

1. The TB Skin Test: Another name of this test, Mantoux tuberculin skin test (TST):

a. It  is performed by injecting a small amount of fluid (called tuberculin, purified protein derivative (PPD) into the skin on the lower part of the arm.

b. The tuberculin skin test must return within 48 to 72 hours to have a trained specialist look for a reaction on the arm.

c. The result depends on the size of the raised, hard area or swelling. Positive results showed bumps on the injected area, and a negative result does not show any kind of swelling or bumps.

2.The TB Blood Test: An Interferon Gamma Release Assay or IGRA, another name of this test.

To check TB germs in the body.  A positive TB skin test or TB blood test only identify that a person has been infected with TB bacteria, not tell about the stage or type of TB.

NOTE: These two test which is mentioned above does not tell about the type od TB it is active TB or Latent TB. TO know more about the Type of diseases we go for advance test for TB, mentioned below:

Advanced Test for TB:

1. Sputum Test: Nucleic Acid Amplification Tests (NAATs)

Procedure: A sample of sputum is added to a substance that promotes the growth of bacteria.

a.If no bacteria grow: the culture is negative.

b.If bacteria grow, the culture is positive.

NOTE: If TB bacteria grow, then the person has tuberculosis. A sputum culture can take 1 to 8 weeks to provide results.

2. Chest X-ray Test: Help to check any kind of damage in Lungs, after identification, we can go for sputum test or culture test to get authenticate results related to diseses.

Ans 2: Isolation precautions:

After identification of TB infections the person must be isolated from the family and society to prevent spread of disease. When someone who has TB infection and the infected persons coughs, sneezes, talks, laughs, or sings, they release tiny droplets that contain the germs. If the nearby people, family members, co-workers, friends etc., breathe in these germs, they can get it.

Ans 3: Recommended treatment:

Two categories of drugs are designed according to the patient medical history related to this disease. More than 20 types of drugs use worldwide in different combination.

Categories of drugs:

First-line drug: This type of drugs are given to people who have never had treatment before.

Second-line drugs: If people have had treatment before they may need to take the second line drugs.

Note: The treatment of disease usually consists of a combination of TB drugs that must be taken for at least six months.

Vaccination: BCG Vaccine,  it doesn’t always protect against infection. More advanced research has been in progress to develop effective vaccine.

Ans 4: Compliance to medication therapy:

The barriers to medication adherence included four concepts, these are:

1. Lifestyle challenges.

2. Patient incompatibility.

3. Forgetting of medicine use.

4. Nonexpert advice.

These concepts are always present in the disease process and reduce the patients' efforts to achieve normal living and adhere to the medication. Some times this improper use of medication make this disease resistance from antibiotics and its very difficult to cure, Drug resistance.

Ans 5: Willson's roommates recommendations: After coming in contact with Willson, they must go for TB blood test to protect their health and their loved ones.