NURS5433 TUBERCULOSIS FNP TEST MUST-KNOW WINTER 2025 UTA

🦠 TUBERCULOSIS – NP TEST MUST-KNOW
🔥 1. Transmission

(COMMON TEST Q)
Airborne (droplet nuclei)
 Requires prolonged, close contact

 ❌
ONLY active pulmonary/laryngeal TB is contagious
Latent TB = NOT contagious

🧠 2. Latent vs Active TB (VERY HIGH YIELD)
Symptoms ❌ None ✅ Present
Feature Latent TB (LTBI) Active TB

Contagious ❌ No ✅ Yes
CXR Normal Abnormal
Sputum Negative Positive

👉
Treatment Prevent progression Full RIPE

👉 90–95% = latent
5–10% = active

⚠️Think:
3. Classic Symptoms of Active TB

Chronic cough (>2–3 weeks) ⭐
“Cough + Constitutional”

 Hemoptysis

Night sweats ⭐
 Fever (low-grade, evening)

Weight loss ⭐


 Fatigue

📸 4. Chest
 Upper lobe infiltrates ⭐
X-Ray Findings (TEST FAVORITE)

 Cavitation (“holes”) = HIGHLY contagious
 Pleural effusion
 Lymphadenopathy

❗ Normal CXR does NOT rule out TB (esp. immunocompromised)

🧪 5. Diagnosis (BIG EXAM AREA)
GOLD STANDARD

👉 Sputum culture
 3 samples on different days
 Takes 1–8 weeks

,Other Tests

 AFB smear
o Fast
o Low sensitivity
o Positive = contagious
 NAAT (GeneXpert)
o Rapid
o Detects rifampin resistance




🧫 6. Screening Tests
QuantiFERON (IGRA)

 Preferred for:
o Healthcare workers
o BCG vaccinated
 More specific




PPD (TST)

 Read at 48–72 hrs
 Measure induration ONLY

PPD Interpretation ⭐
 ≥5 mm → HIV, immunocompromised
 ≥10 mm → healthcare workers, DM, CKD
 ≥15 mm → no risk factors




🔁 7. KEY STEP AFTER POSITIVE TEST (COMMON QUESTION)
👉 ALWAYS get chest X-ray

💊 8. ACTIVE TB TREATMENT = RIPE (TOP TEST Q)
Initial Phase (2 months):

 Rifampin
 Isoniazid

,  Pyrazinamide
 Ethambutol

Continuation (4 months):

 Rifampin + Isoniazid

👉 Total = 6 months

⚠️ 9. DRUG SIDE EFFECTS (VERY TESTABLE)
🔶
Drug Key Side Effect

🔥
Rifampin Orange fluids + drug interactions
Isoniazid Hepatotoxicity + neuropathy → give B6

👁️
Pyrazinamide Hyperuricemia (gout)
Ethambutol Optic neuritis (vision changes)


🧪 10. Monitoring (EXAM PEARL)
 Baseline + monthly LFTs
 Vision testing (Ethambutol)
 Monthly sputum cultures




🧍‍♂️G 11. Latent TB Treatment (FAVORITE BOARD QUESTION)
Preferred:



3HP = INH + Rifapentine weekly x 12 weeks
4R = Rifampin daily x 4 months
⭐
👉 MUST rule out active TB FIRST

⚠️ 12. Who is HIGH RISK for Activation?
 HIV ⭐ (highest)
 Recent infection (<2 yrs)
 Immunosuppression (steroids, TNF inhibitors)
 Diabetes
 CKD
 Malnutrition