LIBRO + ANEXOS NEUMOLOGÍA PEDIÁTRICA

Neumología Pediátrica. Anexos ❚ 133 d. Diagnosis and clinical manifestations 1. History a. Know that the risk for the development of tuberculous disease is greatest within the first two years after initial exposure b. Know that tuberculosis meningitis may have an insidious onset with a prolonged nonspecific prodrome of gastrointestinal symptoms 2. Physical examination a. Know that physical examination of children with active tuberculosis may reveal normal findings or non-specific signs 3. Imaging a. Recognize miliary tuberculosis on an x-ray study of the chest b. Recognize the typical findings of primary tuberculosis on an x-ray study of the chest 4. Pulmonary function tests 5. Other investigations a. Know the technique and diagnostic yield of gastric washing for Mycobacterium tuberculosis culture b. Know the influence of bacille Calmette-Guerin immunizations on tuberculin skin testing c. Know the etiologies of false-negative results of intradermal tuberculin skin tests d. Identify the etiology of false-positive results of intradermal tuberculin skin tests e. Know the utility of bronchoalveolar lavage in the diagnosis of pulmonary tuberculosis f. Know the influence of previous or current infection with atypical mycobacteria on tuberculin skin testing g. Know how to interpret results of a tuberculin skin test in a patient with immunodeficiency h. Know how to interpret results of a tuberculin skin test in immunocompetent patients at low versus high risk of tuberculosis exposure 6. Diagnostic criteria a. Know the likelihood of culturing Mycobacterium tuberculosis from gastric aspirates in various clinical stages of tuberculosis (eg, primary versus cavitary) b. Know how to evaluate a patient for tuberculosis, given that BCG vaccine was previously administered 7. Complications a. Understand the pulmonary complications of untreated primary tuberculosis e. Prevention and therapeutic approach 1. Prevention a. Know the management of a newborn infant whose mother has active tuberculosis b. Describe appropriate methods to evaluate family members in the home of a child with positive results on a tuberculin skin test