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بسم الله الرحمن الرحيم

بسم الله الرحمن الرحيم. Student Case Presentation Tuberculosis Group B2 Community. بسم الله الرحمن الرحيم. Tuberculosis. Introduction to TB Case History and Physical Examination Investigations and diagnosis Management Prevention and Control of TB. Group B2. Tuberculosis.

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بسم الله الرحمن الرحيم

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  1. بسم الله الرحمن الرحيم

  2. Student Case PresentationTuberculosisGroup B2 Community بسم الله الرحمن الرحيم

  3. Tuberculosis • Introduction to TB • Case History and Physical Examination • Investigations and diagnosis • Management • Prevention and Control of TB Group B2

  4. Tuberculosis Introduction • What is Tuberculosis (TB) ? • How Tuberculosis is transmitted ? • What organs does it affect ? Group B2

  5. Tuberculosis Introduction • Between 2000 and 2010 there will be : • 1,000,000,000 person newly infected • 200,000,000 get sick • 35,000,000 will die of TB Group B2

  6. Tuberculosis • Introduction to TB • Case History and Physical Examination • Investigations and diagnosis • Management • Prevention and Control of TB Group B2

  7. Tuberculosis Case History and Physical Examination History of Chief complain : Torki Alsolami is a 23 years old Saudi male patient presented to ER with history of fever for 1 month duration, weight loss, and cough also for 1 month duration. Fever: High grade Sweating: more in the night Cough: no blood stain (no heamoptysis) Sputum with cough: mild no history of contact with T.B patient ... continue Group B2

  8. Tuberculosis Case History and Physical Examination History of Past illness : Medications: -ve Surgeries: previous nasal deformity caused by trauma repaired by surgery Family and social history the patient is non-smoker, no HTN, no D.M, no cholesterol or other chronic illnesses and –ve T.B contact ... continue Group B2

  9. Tuberculosis Case History and Physical Examination Physical Examination • Blood pressure : 111/95 • Pulse : 72/min • General : • General appearance : conscious + oriented • Neck : no lymph node enlargement. • Chest : resonant – equal air entry in both side – bronchial breathing. • CVS : S1+S2+ O • Abdomen : soft + lax + no organomegaly + and presence of bowl sounds . • CNS : intact Temprature: 40o C Respiratory rate: 20/min Group B2

  10. Tuberculosis • Introduction to TB • Case History and Physical Examination • Investigations and diagnosis • Management • Prevention and Control of TB Group B2

  11. Tuberculosis Differential diagnosis : Either Pneumonia or TB Investigations and Diagnosis Investigations : • 2. Blood Chemistry : • Bun = 10 • osmo = 259 • crea = 0.8 • Na = 180 • K = 4.4 • AST = 173 • ALT = 222 • LDH = no reagent • Glucose = 90 • 1. CBC “ complete blood count” • WBC = 8.2 • RBC = 4.57 • Hb = 12 – 8 • Hct = 36.5 • MCV = 80 • MCH = 28. • pH = 7.3 • PT = 15.4 / 13.5 • PTT = 53.3 / 35.5 Group B2

  12. Tuberculosis Investigations and Diagnosis Investigations (continue) : 3. Chest x-ray: patchy or nodular shadows in the upper zones, with loss of volume, and fibrosis with or without cavitation. Provisional diagnosis : By examining the lung carefully … there was right side vesicular sound wich may indicate right side T.B ... continue Group B2

  13. Tuberculosis Investigations and Diagnosis Special investigations : 1. Acid fast stain sputum= +ve“many acid fast bacilli” 2. Mantoux tuberculin skin test “induration = indicates infection with M. tuberculosis Group B2

  14. Tuberculosis • Introduction to TB • Case History and Physical Examination • Investigations and diagnosis • Management • Prevention and Control of TB Group B2

  15. Tuberculosis Management • TB treatment needs long time. and it might be extended up to 12 months. • but basically it needs 6 months. • for thefirst 2 month • Rifampcin • Isoniazid • Pyrazinamide • ethambutol or streptomycinare given,and for thenext 4 monththe first two given. • HIV patients needs2 yearsof that course because ofmultiresistance devloped. • using the 2nd line drugs (clarithromycin..azithromycin and capromycin ) Group B2

  16. Tuberculosis Management Drugs 1. Anti T.B 2. Klacid “ anti-biotic drug 3. ceftriaxone Plus : -ve Pressure room Group B2

  17. Tuberculosis • Introduction to TB • Case History and Physical Examination • Investigations and diagnosis • Management • Prevention and Control of TB Group B2

  18. Tuberculosis Prevention of TB • Case finding & treatment. • BCG( Bacille Calmette Guerin) immunization which is lived attenuated M.bovis and it’s given to the newborns in KSA. • It potentiates the cellular immunity activity and tuberculin test( Mantoux) postivity. • Should’ve not given to HIV patient. Group B2

  19. Tuberculosis Control of TB • Among the case: • Reporting the case • isolation • concurrent disinfection • follow up • Among the contacts: • Mantoux test + chest x-ray+ sputum for AFB • Prophylaxis with rifampcin • follow up and education Group B2

  20. Tuberculosis Hussain Morfeq Yasser Noor elahi Maher Abdulsalam Yasser AL-Qasmi Nabeel Nourah Mohammed Badawod Mohammed Abdulmajeed Motasim Jawi Meshari Bairgdar Mohammad Bukhary Hasan Al-Aidarous Hassan Moria Faisal A. Basonbul Motas Abdulraof Sait Mohammed A.Husni Amro M. Daous Ahmed A. Al-Jubali Ammar Beiary Done by : Group B2 Community Group B2

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