[N-clex] TB(tuberculosis)

Tb risk factor

- immune↓(IV drug, HIV, silicosis(광산, 규폐증), kidney disease, DM, organ transplant, long term steroid)

- immigrated from Tb↑ 나라

- 5y↓

- homeless

- hospital, correctional facilities(교도소), nursing home

 

Tb skin test(PPD : purified protein derivative)

: Intradermal 48~72hr : Induration(hardening/red x)

false positive : BCG

false negative

- viral infection vaccine(MMR, tb반응억제)

- steroid Tx(Asthma 흡입제는 소량이라 영향 X)

- HIV 5mm↑

- malnutrition

- too early 확인

 

Med) use multidrug

- INH : neuritis(prevent : vit B6 복용), aboid tyramin발효e(salami, aged cheeze, chocolate etc.)

- Rifampin : red orange secretion

- PZA :

- ethambutol : optic neuritis

INH, RIF, PZA → hepatotoxicity / INH, RIF, PZA, EMB : oral pill ↓