CCS- How to manage TB? - mykawaiigirl

[ArchivalUser]

TB is a disease of developing and underdeveloped countries

[ArchivalUser]

now if you are the internists, the so called Dr's Dr, you pretend to know everything, you'll recite every haart medicine and side effects and what's best for the patient, impress the medical students, argue with the public health and finally agree on some form of treatment

[ArchivalUser]

UW says:

We dont need to admit all TB patients, ONLY non-compliant patient

rest send home with isoaltion order after starting meds on 3rd day..

[ArchivalUser]

To: gudluckall
RATED SEX :
Recreational drugs and Reassurance
Alcohol
Tobacco
Exercise
Diet of high protein, no lactose, low fat, high fiber
Seat belt, Safety Plan & Suicide Precautions
Education, compliance
X for safe sex

[ArchivalUser]

do we need to keep pt in hospitaal for 2-3 weeks untill his sputum AFB negatcive??

[ArchivalUser]

yes we need to, he poses a threat to the public and should be detained, clear sputum states he is safe, less likely of transmission hence discharge

[ArchivalUser]

not necessarily two weeks but the sputum is clear of AFB, they have classification based on number of bacilli per microscopy view, if you really need beds maybe send those with least amount of bacilli while be on treatment.

They no longer need isolation, after clear sputum but has to be on treatment, detain in non-compliant. The stigma with tb may cause isolation, but they are non-infectious per respiratory droplets wise

[ArchivalUser]

if patient is symptomatic cough with exposure, then isolation. if just exposure or routine no cough, then follow up.
Alos do srum uric acid cos pyrizinamifde causes hyperuricemia

[ArchivalUser]

I am a PGY-1 in IM and in my hospital patient can leave the hospital if admitted with suspected TB and if patient walks out we have to call health dept. They will bring the patient back to hospital for isolation. Now there is no need for q 24 hr order for sputum sample now. we do q 8 hr now for samples. once we start anti TB meds we can d/c isolation bcoz infectivity comes down very fast after starting the treatment

[ArchivalUser]

Thanks mykwaiigirl...... Do we need to every patient with RATED SEX or do only those things which are relevent in those cases like alcohol cessation in alcoholics. Diet suggestions in those with DM, HTN etc.
Thanks and good luck