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advancement instructions > BUMEDINST 6224.8B TB Control Program > Flashcards

BUMEDINST 6224.8B TB Control Program Flashcards

1
Q

What is the TB Control Program instruction number?

A

BUMEDINST 6224.8B

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2
Q

Who is responsible for providing technical support as needed to all Navy and Marine Corps units in their AOR?

A

OICs of NAVENPVNTMEDUs

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3
Q

What is NAVMED 6224/7?

A

Initial TB Exposure Risk Assessment

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4
Q

What is NAVMED 6224/8?

A

TB exposure Risk Assessment

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5
Q

What is NAVMED 6224/9?

A

Monthly evaluation for PTs receiving treatment for Latent TB Infection.

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6
Q

What is NAVMED 6230/4?

A

Adult Imms Record

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7
Q

What is NAVMED 6230/5?

A

Child Imms Record

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8
Q

What is the complex bacteria that causes TB?

A

Mycobacterium Tuberculosis

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9
Q

What is LTBI?

A

Latent Tuberculosis Infection

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10
Q

True or False:

All Navy and Marine Corps accessions must be tested for LTBI unless there is documented or previous TB infections?

A

True

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11
Q

True or False:
All individuals beginning employment as Civilian Mariners for MSC must be tested for LTBI unless there is documented or previous TB infections?

A

True

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12
Q

All personnel must be screened for LTBI during their operations suitability screening after receipt of PCS orders to a commissioned vessel. Screening or testing documentation within how long prior to reporting aboard is acceptable?

A

6 months

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13
Q

When will all active duty and reserve personnel be screened for LTBI other then during accession?

A

during their PHA

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14
Q

During a member’s PHA, what form should be used to determine their TB exposure history and risk of acquiring TB?

A

NAVMED 6224/8

TB risk assessment

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15
Q

what are four examples of additional TB screening other than during a PHA or accession? (4)

A
  1. As directed by combatant commanders.
  2. As part of a contact or outbreak investigation.
  3. if clinically indicated
  4. as recommend by cognizant NAVENPVNTMEDUs
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16
Q

perform TB screening on all personnel prior to or within how long prior to arrival on a commissioned vessel?

A

6 months

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17
Q

Is TB testing required for personnel separating from naval service 6 months before separation or retirement?

A

no

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18
Q

What does PPD stand for?

A

Tuberculin, Purified Protein Derivative

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19
Q

What is the approved tuberculin skin test material?

A

Mantoux test:

Tween-80-stablized intermediate strength

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20
Q

What is the preferred product of tuberose?

A

from Sanofi Pasteur

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21
Q

What is an alternative tuberose product?

A

Aplisol from Parkedale Pharmaceuticals

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22
Q

Record PPD test on one of what two forms?

A

NAVMED 6230/4 or NAVMED 6230/5

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23
Q

The TST reaction must be read between what time after PPD administration?

A

48 to 72 hours

24
Q

If a person returns more that 72 hours after TST placement what do you do?

A

record “not Read” in the record, and apply a TST on the opposite forearm.

25
Q

what must you record as the results for a TST?

A

mm of induration

26
Q

If there is no induction after the administration of a TST what do you record in the record?

A

0mm or zero mm

27
Q

What is available as a as a diagnostic aid for M. Tuberculosis infection?

A

BAMT
Blood Assay for M. Tuberculosis
or a TST

28
Q

What type of BAMT does the Navy use?

A

QuantiFERON-TB Gold (QFT-G)

29
Q

True or False:

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

A

True

30
Q

Based on historical TST results associated with routine screening, the rate of newly-identified LTBI converters is normally no more that __ to __ percent of personnel tested per year in most Navy and MC settings.

A

1-2 percent

31
Q

What is a BCG immunization?

A

Bacillus Calmette Guérin

32
Q

TSTs can be administered to persons who have previously received BCG immunizations however, a positive TST reaction should be regarded how?

A

as indicative of a TB infection and they must be evaluated for active TB prior to receiving treatment for LTBI

33
Q

A TST may be placed on the same day as parenteral live-attenuated virus vaccines or given at least how long later?

A

4 weeks

34
Q

Are TSTs safe during pregnancy?

A

yes

they are both safe and reliable throughout pregnancy and should be administered as appropriate

35
Q

Can you use the two-step procedure for recruit or officer accession screening or other active duty screening programs?

A

no

36
Q

Can members with a positive TST deploy?

A

not until evaluations are completed and all results have been reported

37
Q

evaluate all individuals with a TST induration greater than or equal to __mm to determine if their test is positive.

A

5 mm

38
Q

What are three factors that would place a member into the “high risk” for acquiring TB?

A
  1. Recent close contact of active TB disease PTs
  2. Persons with fibrotic or other changes on chest X-rays with prior TB
  3. PT suspected of having active TB
39
Q

What are three factors that would place a member into the “medium risk” for acquiring TB?

A
  1. Recent immigration (i.e. within the last 5 years) from hight TB prevalence countries.
  2. Mycobacteriology laboratory personnel
  3. persons with clinical conditions that place them at increased risk
40
Q

A high risk PT with a __mm TST reaction is considered to be positive.

A

5mm

41
Q

A medium risk PT with a __mm TST reaction is considered to be positive

A

10mm

42
Q

A low risk PT with a __mm TST reaction is considered to be positive.

A

15mm

43
Q

Chest X-rays should be examined for what changes consistent with old TB?

A

fibrotic

44
Q

A person with suspected active disease should be masked and ____ed immediately and then referred to an appropriate provider at a MTF.

A

isolated

45
Q

If active TB is ruled out and the individual meets the criterion for LTBI, ___ treatment shall be initiated unless medically contraindicated.

A

Isoniazid (INH)

46
Q

what is the preferred INH treatment regimen?

A

5mg/kg (300mg max)
daily
for 9 months to accomplish 270 daily doses within 12 months

47
Q

What is the alternate INH treatment regimen?

A

INH 15mg/kg (900mg max)
Twice weekly
for 9 months
only in combination with directly observed therapy

48
Q

Are baseline laboratory testing routinely indicated for PTs at the start of LTBI TX?

A

no

49
Q

Routine laboratory monitoring is necessary for what individuals?

A

individuals whose baseline liver function tests are abnormal

50
Q

how frequently must individuals receiving therapy for LTBI follow up ?

A

monthly until tx is completed

51
Q

what form is used to document monthly follow ups?

A

NAVMED 6224/9

Monthly Evaluation of PTs receiving Therapy for LTBI

52
Q

If a person gives an undocumented history of positive BAMT or TST without documentation of an adequate course of treatment for LTBI or active TB what do you do?

A

perform a BAMT or TST

53
Q

Where do you document patient education and counseling?

A

SF 600

54
Q

Upon successful completion of appropriate LTBi tx regimen , additional LTBI testing or chest x-rays need to be done?

A

no

55
Q

Do not restart the 9 month daily INH regimen if at least how many doses of INH can be administered within a 12 month period.

A

270

56
Q

What happens if INH treatment has been interrupted for more that two months?

A

PT must be examined to exclude active TB disease

advancement instructions (55 decks)

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