EXAM 5 TB Pastakia

Question 1

TST testing

Answer 1

Positive result: acquired immune response, Latent TB, Subclinical TB, Active TB

Question 2

IGRA: QuantiFERO

Answer 2

Positive result: acquired immune response, Latent TB, Subclinical TB, Active TB

Question 3

Culture

Answer 3

Intermittently Positive result: Subclinical TB
Positive result: Active TB

Question 4

Sputum smear

Answer 4

Positive/negative result: Active TB

Question 5

Which LTBI medication would typically want to avoid/ be cautious with in patients living with HIV?

Answer 5

Rifampin – CYP inducer
Takes couple days to weeks to see effect

Question 6

Drug Susceptible TB

Answer 6

TB strains that are sensitive to standard first-line agents

Question 7

Monoresistant TB

Answer 7

TB strains that are sensitive to just one anti-TB drug

Question 8

Polyresistant TB

Answer 8

TB strains that are resistant to more than one anti-TB drug but not INH and RIF

Question 9

Multidrug resistant (MDR) TB

Answer 9

TB strains that are resistant to RIF and INH

Question 10

Extensively drug-resistant (XDR) TB

Answer 10

Resistant to RIF and INH

+ at least one injectable agent (amikacin, kanamycin, or capreomycin)

+ any of the fluoroquinolones

Question 11

Resistance in TB is slightly different than other bacteria

Answer 11

Spontaneous resistance occurs: why we need combo therapy

Rifampin: 10^-8

Isoniazid + pyrazinamide: 10^-6

Question 12

Treatment of drug susceptible TB

Answer 12

Standard 6 month regimen
Rifapentine-based 4 month treatment

Question 13

Standard 6 month regimen

Answer 13

Rifampin 600 + isoniazid 300 + ethambutol 800-1600 + pyrazinamide 1000-2000

Continuation phase: rifampin 600 + isoniazid 300 QD 18 weeks

Question 14

Rifapentine-based 4 month treatment

Answer 14

Rifapentine 1200 + isoniazid 300 + moxifloxacin 400 + pyrazinamide 1000-2000

Continuation phase: rifapentine 1200 + isoniazid 300 + moxifloxacin 400 QD 9 weeks