6.18

Question 1

BUMEDINST 6224.8

Answer 1

TB Control Program

Question 2

Elements of the TB Control Program

Answer 2

TB Screening
Prev therapy
TB Case ID
TB PT Mgt
Contact Investigation

Question 3

Tuberculin Skin test is also called?

Answer 3

Mantoux method

Question 4

What does PPD stand for?

Answer 4

Purified Protein Derivative

Question 5

Types of PPD

Answer 5

Tubersol
Aplisol

Question 6

IGRA- What does it do

Answer 6

Interferon Gamma Release Assays
Detects mycobacterium tuberculosis infection

Question 7

Approved IGRA’s

Answer 7

QFT
QFT PLUS
T- Spot

Question 8

Mycobacterium TB

Answer 8

Bacteria that cause Latent and active TB

Question 9

Define Active TB

Answer 9

TB Bacteria actively multiplies and attacks the body

Question 10

Latent TB

Answer 10

TB bacteria alive but inactive, non infectious

Question 11

BCG

Answer 11

A vaccine, rare in US

Question 12

Antibiotic regimen for LTBI

Answer 12

INH & Rifapentine, oral, weekly, 15mg/kg INH, 10-14 mg/kg RPT
3 months

Question 13

Alternate regimen for TB

Answer 13

Rifampin, daily 10mg/kg
4 months
INH and Rifampin in an daily dose: 5mg/kg INH, 10mg/kg RFT

Question 14

Who gets screened for TB

Answer 14

Everyone entering active duty
CIVMAR and MSC

Question 15

What must be provided from a civilian employee if you have no medical records on them?

Answer 15

Clinical evals
Hospitilizations
Dx
Treatments

Question 16

High Risk TST

Answer 16

5+mm induration
Close contact
Changes in Radiograph
Suspected TB

Question 17

Medium Risk TST

Answer 17

10+mm induration
Recent immigrant (5years) from TB countries
Healthcare workers
Conditions that put them at greater risk

Question 18

Low risk TST

Answer 18

15+mm Induration
People with no risk factors for TB

Question 19

Preferred method for admin. PPD

Answer 19

Mantoux method

Question 20

PPD dosage

Answer 20

.1 ml

Question 21

What angle do we insert the PPD needle?

Answer 21

5-15 degrees

Question 22

How big of an induration do we want for PPD

Answer 22

6-10mm

Question 23

If you fail a PPD, where else can we give it?

Answer 23

2 inches away
other arm

Question 24

When can we interpret PPD

Answer 24

48-72 hours

Question 25

Where do we record PPD?

Answer 25

NAVMED 6230/4
DD 2766
AHLTA
MRRS

Question 26

Reasons for False negatives

Answer 26

Immunosuppression
Received a live virus recently (within 4 weeks)

Question 27

What must the evaluation for TB include before TST, IGRA?

Answer 27

Clinical Hx
Physical Exam
Chest xray
Sputum sample (Xray = TB)
LFT and bilirubin

Question 28

Follow up for INH therapy

Answer 28

Done Monthly
Document on NAVMED 6224/9

Question 29

What do we do for Non Compliance

Answer 29

Consult NEPMU
Direct Observed therapy

Question 30

SGOT

Answer 30

Serum Glutamic Oxaloacetic Transaminase

Question 31

SGPT

Answer 31

Serum Glutamic Pyruvic Transaminase

Question 32

INH therapy can do what to your liver?

Answer 32

Raise Enzyme levels (SGOT/SGPT)

Question 33

When should you consider holding INH from a patient?

Answer 33

levels 3 times the amount with sxs
levels 5 times the amount without sxs

Question 34

If you discover someone with TB what is an additional thing you do?

Answer 34

Contact investigation, call NEPMU

Question 35

If you are separating and get diagnosed with TB. Who do you follow up with for Tx?

Answer 35

VA

Question 36

Who is ultimately responsible for contact investigations?

Answer 36

CO

Question 37

Where do contact investigations get submitted to and from who?

Answer 37

MERS, NEPMU

Question 38

Active TB: Sxs, Tx,

Answer 38

Cough, weight loss, fatigue, fever, loss of appetite, chills and night sweats
Anti TB drugs - Bactericidal and bacteriostatic

Question 39

Preferred treatment schedule of TB

Answer 39

2 months aggressive
4-7 months continuation phase

Question 40

Intensive phase tx

Answer 40

7d/wk 56 doses
5d/wk 40 doses

Question 41

Continuation Phase

Answer 41

7d/wk 126 doses
5d/wk 90 doses