***2019 (quick)*** BUMEDINST 6224.8B TUBERCULOSIS CONTROL PROGRAM Flashcards
TB Instruction?
6224.8B
Initial TB exposure risk assessment?
NAVMED 6224/7
Interim TB exposure risk assessment?
NAVMED 6224/8
Monthly evaluation for treatment?
NAVMED 6224/9
Bacteria causing TB?
Mycobacterium tuberculosis
Screen or test how long before reporting to commissioned vessel?
6 Months
NAVENPVNTMEDU
Navy Environmental Preventive Medicine Unit
PPD
Purified Protein Derivative
Approved material for routine Mantoux test?
Tween-80-stabilized intermediate strength (5 TU equivalent)
Preferred PPD product?
Tubersol (Aplisol is 2nd choice)
TST should be read when?
48-72 hrs
If pt returns beyond 72 hrs for reading?
Record the result as “not read” on SF 601 and apply TST on opposite forearm
If there is no induration, record result as?
“0 mm” or “zero mm”
Rate of newly-identified LTBI converters?
1-2% of personnel tested per year
If conversion rate is two times greater than expected baseline?
Contact NAVENPVNTMEDU for guidance
A positive TST reaction in BCG immunized person should be regarded as what?
TB infection
A TST may be placed the same day as live-attenuated virus or?
At least four weeks later
TST for pregnant service members?
Considered safe and reliable (may still rule out with x-ray)
Increase in reaction size of 10mm or more within ___ years is considered positive
3
High risk?
5mm or more w/recent close contact of infected patients
Medium risk?
10mm or more in recent immigrants or clinical conditions i.e. lab personnel
Low risk?
15mm or more is positive if NO risk factors
ICD-9-M code for TB?
V74.1 “Screening Exam for Pulmonary Tuberculosis”
Examine chest x-rays for?
Fibrotic changes
INH?
Isoniazid
Disease Alert Report?
MED 6220-3
PPD single dose amount?
0.1 ml (5 TU) PPD
A good intradermal injection will be evidenced by?
Small, pale, sharply demarcated wheal
Measurement of induration between two millimeter divisions of the scale should be rounded up or down?
DOWN
Consider searching for an active case of TB disease in the command if reactors is greater than what percent?
2.5%
Ignore what vaccine history when evaluating for routine PPD?
Bacillus Calmett-Guerin (BCG)
Positive PPD still indicative of TB infection
INH, length of treatment?
5 mg/kg Daily for 9 months. 270 daily doses within 12 months
What lab tests should be performed when initial evaluation suggests elevated risk for liver disease or INH induced hepatoxicity?
Alanine Aminotransferase and bilirubin
Consider withholding INH if transaminase levels exceed?
3-5 times the upper normal limit
ICD-9-M (Internaltional Classification of Disease) code for patients receiving therapy?
V68.1 (issue of repeat prescriptions)
What should be used for persons who are at very high risk for developing active TB?
DOT (Directly observed therapy)
Wear what particulate respirator in TB rooms?
N95 (minimum)
Suspected new cases?
Submit medical event report w/in 24 hrs. Submit second report when disease is ruled in/out.
BAMT
Blood Assay for M. Tuberculosis infection
AHLTA
Armed Forces Health Longitudinal Technology Application
