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PREV MED > 6.18 Tuberculosis Surveillance and Control Program > Flashcards

6.18 Tuberculosis Surveillance and Control Program Flashcards

1
Q

Elements of TB Control Program

A 
Tuberculosis screening
Preventative therapy 
Tuberculosis case identification 
Tuberculosis patient management 
contact investigation
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2
Q

Approved Tuberculin Skin Test

A 
Mantoux Method 
Purified Protein Derivative (PPD)
- Tubersol (preferred)
- Aplisol (alternative)
1/4in-1/2in needle 27 gauge
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3
Q

IGRA

A

Interferon Gamma Release Assays to detect TB

FDA approved

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4
Q

Quanti-Feron TB Gold

A

QFT

is designed for use in place of, not addition to a TST

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5
Q

Mycobacterium Tuberculosis

A

bacteria that cause latent TB infection and active TB disease

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6
Q

Active TB disease

A

illness with TB bacteria are multiplying and attacking the body

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7
Q

Latent TB infection

A

a condition that TB bacteria are alive but inactive in the body
cant spread to others, dont feel sick

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8
Q

TB Skin Test

A

a test used to find out if you have TB

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9
Q

TB Blood test

A

new test that uses blood to test for TB

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10
Q

BCG

A

TB Vaccine named after French scientist, Calmette and Guerin
RARELY used in US. often given to infants and small children in other countries where TB is common

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11
Q

Direct Observed Therapy

A

DOT

helping patient take their meds for TB

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12
Q

Latent Tuberculosis Infection LTBI Treatment

A 
Isoniazid (INH)
Rifapentine (RPT)
Oral weekly dose 15mg/kg (900mg max)
10-14kg 300mg
14.1-25kg 450mg
25.1-32kg 600mg
32.1-49.9kg  750mg
>50kg 900mg
for three months
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13
Q

Rifampin (RIF)

A

10mg/kg 600mg max

4 months

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14
Q

When a person has a history of active TB they must provide documentation of:

A

clinical evaluations
hospitalizations
diagnosis
treatment

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15
Q

When do people get screened for TB?

A

PHA

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16
Q

What is the TB screening documented on?

A

NAVMED 6224/8

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17
Q

Chest radiograph requirements

A

if clinically indicated

to rule out active TB or fibrotic changes

18
Q

High risk INH

A

induration of 5mm or greater

  • recent close contacts
  • fibrotic changes
  • suspected of active TB
19
Q

Medium Risk INH

A

induration of 10mm
- recent immigrants
healthcare workers

20
Q

Low risk INH

A

15mm or greater induration

- no risk factors for TB

21
Q

Mantoux Method

A

standard method for testing for TB

22
Q

PPD Administration

A

0.1mL on the volar aspect of forearm
5-15degree angle
tense pale wheal that is 6-10mm
** if less than 6mm test should be administered again

23
Q

When is the TST read?

A

48-72 hours

24
Q

Not recorded as

A

Negative or positive

25
Q

After 72 hours

A

result as not read - apply TST on opposite arm

26
Q

Possible reasons for false negative TST results

A

immunosuppression due to TB infection
receipt of immunosuppressive meds
immune system compromising conditions
TST administered within a short period after live vaccine

27
Q

When can a TST be placed in regards to live vaccines?

A

placed on same day - if given first

at least four weeks after live vaccine

28
Q

Who can evaluate for TB?

A

MO, PA, NP or IDC

29
Q

evaluations must include

A

appropriate clinical hx
physical exam
chest X ray
Sputum exam - only if chest x ray shows active TB
baseline liver function test and bilirubin

30
Q

questions to address

A

is active disease present?
any contraindications to INH present?
should INH be prescribed and for what duration?

31
Q

Monthly evaluations are documented on what form?

A

NAVMED 6224/9

32
Q

Noncompliance of INH

A

consult with NEPMU
DOT
- twice weekly
- difficulty with treatment adherence

33
Q

Serum Glutamic Oxaloacetic Transaminase (SGOT)

A

consider withholding INH therapy if transaminase levels exceed 3 times the upper limit - w/ sx
OR
5 times the upper limit - w/o sx

34
Q

Who does the MDR notify when someone is dx with TB?

A

NEPMU

35
Q

Personnel who are seperating from service but enrolled in contact investigation

A

can get their meds from local public health or VA

36
Q

What is the MDR responsible for in regards to reporting TB?

A

ensuring the contact investigation is initiated rapidly

37
Q

Reports of TB contact investigation

A

provided by cognizant NEPMU to:
members of command
cognizant FLEET/TYCOM surgeon
Navy and Marine Corps Public Health Center

38
Q

How fast are MERs submitted?

A

within 24 hours

39
Q

Anti tuberculous drugs are classified as

A

Bactericidal

Bacteriostatic

40
Q

Different meds for TB

A

Isonizaed
Rifampin
Pyrzinamide
Ethambutol

41
Q

Complications to active TB

A

Extrapulmonary TB infection

INH associated hepatitis

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