Health Questions and Answers

Archive for the 'Tuberculosis' Category

Question: What can be done for TB Symptomatics who are unable to spontaneously expectorate sputum?

Friday, December 28th, 2007

Answer:

Sputum induction with nebulization of a hypertonic (3%) saline solution is recommended for patients who are unable to spontaneously bring up sputum
Three specimens will increase diagnostic yield of the sputum microscopy test of induced specimens
The use of nebulization with hypertonic solution is an alternative that must be maximized in order to avoid further invasive procedures
Clinics [...]

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Question: How should results of sputum microscopy be interpreted?

Friday, December 28th, 2007

Answer:

SMEAR POSITIVE if at least two sputum specimens are AFB (+)
SMEAR NEGATIVE if none of the specimens are AFB (-)
DOUBTFUL When only one of the 3 sputum specimens is (+).

When results are doubtful, a second set of three must be collected again
If at least one of the second three is (+), the diagnosis is SMEAR [...]

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Question: How should sputum be collected when working up for TB?

Friday, December 28th, 2007

Answer:

Patients must be encouraged to bring up sputum and not saliva.
Sputum collected first thing in the morning for three consecutive days is recommended
Other modified schedules to allow collection in the shortest number of days and clinic visits is likewise acceptable. Advice the patients to collect three sputum specimens within two days as follows:

First Specimen: Spot [...]

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Question: What is the initial work-up for a TB symptomatic?

Saturday, December 22nd, 2007

Answer:

The initial work-up of choice for a TB symptomatic is the sputum microscopy. All patients who present with cough of two weeks or more should preferably have three, but, at the least two sputum specimens sent for sputum microscopy for Acid Fast Bacilli (AFB)
Sputum microscopy is still the most efficient way of identifying cases of [...]

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Question: When should one suspect that a patient may have PTB?

Saturday, December 22nd, 2007

Answer:

Cough with or without the following: night sweats, weight loss, anorexia, unexplained fever and chills, chest pain, fatigue and body malaise, is suggestive of TB.
A patient exhibiting cough of two weeks or more with or without accompanying symptoms will be referred to as a TB Symptomatic

Reference:

Tattevin P, Casalino E, Fleury L, Egmann G, Ruel M, [...]

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