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EPI DISEASES. 1. Tuberculosis. Consumption. Koch’s Disease. Pthisis. Mycobacterium tuberculosis. CAUSATIVE AGENT. Mycobacterium tuberculosis, TB bacillus, Koch’s bacillus, Mycobacterium bovis. MODE OF TRANSMISSION. Airborne, droplet. Incubation Period : 4 – 6 weeks.
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1. Tuberculosis Consumption Koch’s Disease Pthisis
Mycobacterium tuberculosis CAUSATIVE AGENT Mycobacterium tuberculosis, TB bacillus, Koch’s bacillus, Mycobacterium bovis
MODE OF TRANSMISSION Airborne, droplet Incubation Period: 4 – 6 weeks
PATHOGNOMONIC SIGNS 1. Usually asymptomatic 2. low grade afternoon fever 3. night sweating
5. weight loss 6. easy fatigability 7. temporary amenorrhea
MANAGEMENT/TREATMENT Diagnostic test: Sputum Examination, Chest X – ray, tuberculin testing.
Sputum Examination or the acid fasting bacilli (AFB). 1. The confirmatory test. 2. early morning sputum about 3 – 5 cc 3. maintain NPO before collecting the specimen 4. give oral care after the procedure 5. label and send to the laboratory
1. determine the clinical activity of TB if TB is inactive(in control) or active (ongoing)
2. To determine the size of the lesion: • Minimal – very small • Moderately advanced – lesion is less than 4cm • Par advanced – lesion is more than 4 cm
Purpose – to determine the history of exposure to TB. Uses PPD (purified protein derivative) Principle: If the person is exposed to TB he will develop PPD – leading to indurations of >10mm.
Other name: Mantoux test – for individual screening, result interpreted after 72 hours.
Tine test – mass screening, read after 48 hours. Treatment: Short Course Chemotherapy, DOTS Ripamficin, Izoniazid, Pyrazinamide, Ethambutol, Streptomycin
Category of Treatment Regimen for DOTS • Category 1: 6 months SCC • Intended for: • New positive smear • New negative smear PTB with extensive parenchymal lesions on CXR • EPTB • Severe concomitant HIV disease
Intensive phase: 2 months • R - ifampicin (R) 1 tab • I - soniazid (H) 1 tab • P - yrazinamide (Z) 2 tabs • E - thambutol (E) 2 tabs • Continuation phase: 4 months • R - ipamficin (R) 1 tab • I – soniazid (H) 1 tab
Category 2: 8 months SCC • Intended for: • Treatment failure • Relapse • Return after default
Intensive phase: 3 months • R - ifampicin (R) 1 tab • I - soniazid (H) 1 tab • P - yrazinamide (Z) 2 tabs • E - thambutol (E) 2 tabs • S - treptomycin (S) 1 vial/day • Continuation phase: 5 months • R - ipamficin (R) 1 tab • I – soniazid (H) 1 tab • E - thambutol (E) 2 tabs
Category 3: 4 months SCC • Intended for: • PTB minimal • Negative sputum smear
Intensive phase: 2 months • R - ifampicin (R) 1 tab • I - soniazid (H) 1 tab • P - yrazinamide (Z) 2 tabs • Continuation phase: 2 months • R - ipamficin (R) 1 tab • I – soniazid (H) 1 tab
Side Effects of TB Drugs • Rifampicin– orange colored urine, hepatotoxic • Isoniazid– peripheral neuritis • Pyrazinamide – hyperuricemea/gouty arthritis • Ethambutol– optic neuritis • Streptomycin – damage to the 8th cranial nerve, ototoxic
Prevention 1. Avoid Mode of Transmission
Hepatitis B Serum Hepatitis
CAUSATIVE AGENT Hepatitis B virus
MODE OF TRANSMISSION Blood and body fluids Placenta Incubation period: 45 – 100 days
PATHOGNOMONIC SIGNS • Abdominal pain 2. Jaundice 3. yellow colored sclera 4. anorexia 5. nausea and vomiting 6. muscle pain
MANAGEMENT/TREATMENT Diagnostic test: HBsAg (Hepatitis B surface Agglutination test) Treatment: Hepatitis B immunoglobulin
PREVENTION Hepatitis B Vaccine
Hepatitis A Infectious Hepatitis Epidemic Hepatitis Catharral jaundice
CAUSATIVE AGENT Hepatitis A virus