CPM 7th Edition

Question 1

Incubation period of TB refers to the time the tubercle bacilli enter the body until

Answer 1

Tissue hypersensitivity develops, ie (+) TST

Question 2

Incubation period of TB

Answer 2

19-56 days or 3-8 weeks

Question 3

Ghon focus is usually located in

Answer 3

Subpleural area of the upper segment of the lower lobe or in the lower segment of the upper lobes

Question 4

Tissues that favor retention and bacillary multiplication

Answer 4

apical posterior areas of the lung, LN, kidneys, vertebral bodies, epiphysis of long bones

Question 5

Timetable that describes the usual early course and timing of the initial Tb infection and its common complications

Answer 5

Wallgren’s timetable

Question 6

Based on Wallgren’s timetable, complications from TB are especially expected to occur when

Answer 6

First year

Question 7

TB lesions involving bones and joints seen in 5-10% of infected children do not appear until ___

Answer 7

At least a year after initial infection

Question 8

TB lesions involving the kidneys do not appear until ___

Answer 8

15-25 years after initial infection

Question 9

Symptomatic, massive lymphohematogenous spread of TB, ie miliary or acute meningeal Tb is rare and seen in only ___% of affected children

Answer 9

0.5-3%

Question 10

Symptomatic, massive lymphohematogenous spread of TB, ie military or acute meningeal Tb usually occurs ___ after initial infection

Answer 10

2-6 months

Question 11

Criteria for TB exposure or Class I

Answer 11

Exposure to an adolescent/adult with active TB

Question 12

Criteria for TB infection or Class II

Answer 12

1) ± history of exposure 2) (+) TST

Question 13

Highest risk of developing TB is seen in infants, developing in up to ___% of infants within 3-9 months of infection

Answer 13

50%

Question 14

Risk of developing TB is ___% in CHILDREN 1-5 years of age within 1-2 years

Answer 14

25%

Question 15

Risk of developing TB is ___% in adolescents

Answer 15

15%

Question 16

Criteria for TB disease or Class III

Answer 16

3 or more of the ff: 1) Exposure 2) (+) TST 3) Signs and symptoms suggestive of TB (at least 1) 4) (+) CXR 5) (+) Lab findings

Question 17

Signs and symptoms suggestive of TB

Answer 17

1) Cough/wheezing >2 weeks; fever >2 weeks 2) PAINLESS lymphadenopathy 3) Poor weight gain; failure to make a quick return to normal

Question 18

Who should be investigated for miliary TB

Answer 18

Infants or children <2 years of age who present with fever, cough, pallor, weight loss, with or without hepatomegaly/splenomegaly

Question 19

Criteria for TB inactive or Class IV

Answer 19

1) ± previous chemotherapy 2) + radiographic evidence of healed/calcified TB 3) + TST 3) No signs or symptoms suggestive of TB 4) Smear/culture for M. tb negative

Question 20

T/F: The younger the patient, the greater the risk of progressive TB disease

Answer 20

T

Question 21

T/F: In TB disease, young infants and adolescents are more likely to have significant signs and symptoms than school-aged children

Answer 21

T

Question 22

T/F TB pleurisy with effusion is an early complication of primary infections

Answer 22

T

Question 23

Lung lobe that is most vulnerable when there is enlargement of the hilar LN

Answer 23

Right middle lobe followed by the right upper lobe

Question 24

Miliary tb which results from

Answer 24

Discharge of a caseous focus into the blood vessel

Question 25

Type of TB infection seen in a host previously sensitized by earlier Tb infection, characterized by apical or infraclavicular infiltrates often with cavitation and NO hilar lympadenopathy

Answer 25

Chronic PTb

Question 26

T/F Tuberculomas are a common condition, affecting a significant number of untreated TB infections in children

Answer 26

F, only 0.4%

Question 27

T/F Pericardial Tb is a common condition

Answer 27

F

Question 28

T/F Enlarged cervical LN in Filipino children are more often caused by infections other than TB

Answer 28

T

Question 29

MC Tb of the CNS

Answer 29

TB meningitis

Question 30

TB meningitis complicates ___% of untreated Tb infections

Answer 30

0.3%

Question 31

MCC of mortality from TB below age 3 years

Answer 31

TB meningitis

Question 32

TB meningitis is frequently seen in what age group

Answer 32

First 6 years of life

Question 33

TB meningitis is rare in what age group

Answer 33

First 4 months

Question 34

TB meningitis accompanies military Tb in approx ___% of cases

Answer 34

50

Question 35

Cranial nerves involved in CNS Tb

Answer 35

III, VI, VII, and optic chiasm

Question 36

A negative TST rules out TB meningitis

Answer 36

F

Question 37

Tuberculoma vs Abscess: More common in CNS Tb

Answer 37

Tuberculoma

Question 38

Tuberculoma occur most often in children of what age

Answer 38

Less than 10 y/o

Question 39

Tuberculomas are most often located at

Answer 39

Base of brain around the cerebellum

Question 40

Tb of bone and joints are more common in younger vs older children

Answer 40

Younger, due to increased blood flow in growing bones

Question 41

Tb of bone: Multiple vs single vertebral body

Answer 41

Multiple

Question 42

Next to spine, these joints appear to be susceptible to implantation and proliferation of Tb bacilli

Answer 42

Hips, knees, and ankles

Question 43

Tb of skin overlying a caseous LN that has ruptured to the outside, leaving an ulcer or a sinus

Answer 43

Scrofuloderma

Question 44

Ocular Tb is uncommon in children, but when present, frequently involves

Answer 44

Conjunctiva and cornea

Question 45

MC ocular manifestation in patients with systemic Tb

Answer 45

Choroiditis