Ix and management

Question 1

Name 4 major investigations that must be carried out?

Answer 1

1. Specialist stain
2. Bacterial cultures - blood/sputum
3. CXR
4. Mantoux / IGRA testing

Question 2

How are patients at the risk of reactivation of latent TB managed?

Answer 2

1. Isoniazid and Rifampicin for 3 months

or

2. Isoniazid alone for 6 months

Question 3

How is acute pulmonary TB managed?

Answer 3

1. R - rifampicin 6 months
2. I - Isoniazid for 6 months
3. P- pyrazinamide for 2 months
4. E - ethambutol for 2 months

Question 4

What should be prescribed alongside Isoniazid?

Answer 4

1. Isoniazid causes peripheral neuropathy

2. Pyridoxine - vitamin B6 should be prescribed as a prophylaxis

Question 5

Name two side effects of Ethambutol?

Answer 5

1. Colour blindness

2. Reduced visual acuity

Question 6

Which of the RIPE drugs caused gout?

Answer 6

Pyrazinamide may cause hyperuricaemia resulting in gout.

Question 7

Name two important considerations to take into account when prescribing Rifampicin?

Answer 7

1. red / orange discoloration of urine and teas

2. induces P450 enzymes

Question 8

Which 3 RIPE drugs are associated with hepatotoxicity?

Answer 8

1. Rifampicin
2. Isoniazid
3. Pyrazinamide