Lucy Said:

why would someone born in the Netherlands get a false positive on a PPD TB test?

We Answered:

the family of bacteria common to the tuberculosis family yet not actually TB could cause a false positive on the test, the nontuberculosis myobacteria is the same genus as TB and hence the PPD antigen would respon to that as well.

If he is immunized for TB that would also produce a positive result despite no infection.

Stella Said:

what do you think about equine science degree?

We Answered:

There are very few jobs and every job a new graduate gets is from connections and networking. For example, I would rather hire a person I know has experience in TB management, rather than a person who has just a degree in TB management. That is the problem with so many people with equine degrees is that they just get the degree and think that is enough.

In our barn, we had a girl interview for our barn manager position when is was open a few years ago, in charge of boarders, lesson scheduling, vet, farrier, ordering hay/shavings, you know, all the good stuff that comes with the job! The girl had an impressive Bachelors degree with the University of Findlay in Stable Management and her resume included a few years of weekly lessons, and participating in the Equestrain club at school (not the big, nationally know team, just the club). The other person who interviewed had a small Associates degree in finance, but she assisted in managing a TB breeding farm, participated in dozens of clinics, was a working student for two or three top h/j trainers, and she retraining and rehoming OTTBS in her own time. Who would be the better candidate? We offered it to the one with the Associates degree in an unrelated field and our barn has never been so well managed. She had more experience with horses and barn management than the other girl could even imagine.

If you can meet lots of people while you are in school and participate in as many horsey activites as possible, your chances are just a tad increased. There aren't many jobs out there, but if you search hard enough and are willing to relocate, you might find some!

Marion Said:

Case studies - Following on from Truth telling Question.?

We Answered:

Tough questions - good job!! If I'd seen the recently-retired 65 y/o male with pancreatic cancer, I believe it would be absolutely necessary to tell him his diagnosis. As treatment for metastatic pancreatic cancer is, as far as I can recall, palliative at best, I believe he would appreciate knowing his diagnosis and what the current treatment options are. This is a guy who's probably used to being in charge and meeting challenges head-on. In all likelihood, he would probably choose to go on the cruise with his wife to have the "time of his life", rather than risk losing any time, wasting away in a hospital bed. I've had patients tell me they'd rather spend their (last) days living instead of dying. I also think it would be a tragic disservice, not to mention gross malfeasance, to my patient if I told him it appeared to be something benign and he found out later from someone else that he'd had a terminal condition and hadn't spent his last days as he'd wished.

The 78 y/o Asian female is a bit tougher. Taking her family's cultural background into consideration, I'd still strongly recommend initiating treatment, as pulmonary TB is very treatable, even in the geriatric patient population. And, with the family (those in close contact with the patient) being treated prophylactically, treating "our" 78 y/o patient for her "infectious pneumonia" would be much easier for her to tolerate in the presence of family who love and revere her. The clinical diagnosis of "pulmonary tuberculosis" would not necessarily need to be voiced unless she was unable to tolerate standard treatment regimens and needed an Infectious Disease (sub-specialist) consult.

Esther Said:

how to make the pathophysiology part in a case study?

We Answered:

just take it from there if you know TB stage 3 symptoms and findings such as: she came back to the hospital complaining of night sweats, accompanied by chills and noticed her appetite had been decreasing and maybe she lost alot of weight in a short time..she's been coughing up blood and has a gradual onset of chest pain aggravated by deep breathing that does not radiate. In end stage she would have distended neck veins, pitting edema, enlarged and tender liver from polycythemia and cor polmonale also digital clubbing, cyanosis, dull percussion noted in lungs, all vital signs will be increased, all lung volumes and capacities will be decreased...her ABG will have a normal pH, high CO2, high HCO3, and low Pao2, positive AFB, On CXR-increased opacity, cavity formation, calcification and fibrosis just make up any story but add these in and don't forget the patients smoking history and working history maybe she worked wherever a lot of dust might've been around...hope this helped a little...good luck on your paper.

Leon Said:

calling all who are in medical field,help me with this one please?

We Answered:

Are u a filipino student nurse?!

Nothing just asking...anyway,

You could try searching the Library about the Tubreculosis on Pathophysiology books.

If in any instance that you study in RTRMS, try the 9th floor doctor's library on MMC, it has lots of books about infectious diseases.

But if you don't know anything I'm talking about, I say you refer to all the Pathophysiology books that you get your hands on in the Library and start looking for Tuberbulosis. Having lots of references will help you in research, and not the short cuts that you are doing here. Anyway, I also do case studies about bronchopneumonia with bronchial asthma in acute exacerbation and reading a lot of books helped me in tracing the pathophysiology of the disease. Hope I helped. Good luck in your case.