Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OS 217 Infectious Diseases > Lec 16 Extrapulmonary Tuberculosis > Flashcards

Lec 16 Extrapulmonary Tuberculosis Flashcards

1
Q

The most common misconception about the etiology of TB

A. bacteria
B. fatigue
C. smoking
D. alcohol
E. genetic
A

smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Enumerate the 5 pillars of DOTS (Directly Observed Treatment, Short-Course)

A 
quality-assured smear microscopy
uninterrupted supply of anti-TB drugs
directly observed treatment (DOT)
program and patient monitoring
political will
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

The name of the UP TB DOTS clinic is

A

UP PRIME TB DOTS Clinic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the meaning of PRIME?

A

PGH Responsive Integrated Multidisciplinary Enhanced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Who is the head of UP PRIME TB DOTS?

A

Dr. Camilo Roa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

TB is spread internally through what route?

A

hematogenous and lymphatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Early caseous necrosis is first seen in what clinical stage of TB?

A. 1
B. 2
C. 3
D. 4a
E. 5
A

Stage 1: onset
Stage 2: symbiosis
Stage 3: early caseous necrosis
Stage 4a & 4b: interplay of cell-mediated immunity and tissue-damaging delayed-type hypersensitivity
Stage 5: liquefaction and cavity formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When is coughed sputum best collected?

A

early morning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How many samples of AFB (+) sputum are needed to confirm diagnosis?

A

2 samples

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

T/F: AFB smears are highly sensitive.

A

F, only 30-40% sensitive

40-50% in PGH due to immunofluorescence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

T/F: (+) AFB is diagnostic for Mycobacterium tuberculosis.

A

F, all acid-fast bacilli look alike

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the gold standard for TB diagnosis?

A

culture and identification of isolate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

True of TB culture EXCEPT

A. usually takes 2-4 weeks
B. signed out as negative until 6 weeks
C. ID based on biochemical tests
D. cannot distinguish among MTB complex
E. NOTA
A

B

Do not sign out as negative until 8 weeks.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

True of tuberculin skin test

A. (+) is not diagnostic of PTB
B. (-) excludes TB as possible diagnosis
C. AOTA
D. NOTA

A

A

(+) only SUPPORTS but not diagnostic
(-) result DOES NOT exclude TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

T/F: Interferon Gamma Release Assay (IGRA) is diagnostic of TB.

A

F, for screening only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

ID: Newest TB test endorsed by WHO due to near 100% TB sensitivity and ~92% rifampicin resistance sensitivity.

A

Gene Xpert

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

ID: Findings in chest X-ray of TB patient.

A

infiltrates, nodular densities, cavities, with or without hilar lymphadenopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

T/F: TB patients co-infected with HIV has higher load of bacteria.

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

T/F: TB patients co-infected with HIV has higher transmission risk and more infectious than TB patients w/o HIV.

A

F, HIV patients may have lesser cavitations in the lungs (due to poor immune response)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

The standard regimen for TB is

A

HREZ x 2 months then HR x 4 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which first line TB drug is bacteriostatic?

A. isoniazid
B. rifampicin
C. ethambutol
D. pyrazinamide

A

C. ethambutol

22
Q

All of the first line TB drugs are metabolized in the liver EXCEPT

A. isoniazid
B. rifampicin
C. ethambutol
D. pyrazinamide

A

C. ethambutol (renally excreted)

23
Q

ID: Hearing loss is an adverse effect of what 2nd line TB drug?

A

streptomycin

24
Q

T/F: There are fewer problems with anti-TB drug toxicity in children.

A

T

25
Q

MDR TB is resistant to what drug/s?

A. isoniazid
B. rifampicin
C. ethambutol
D. pyrazinamide
E. AOTA
A

A & B

26
Q

ID: XDR TB is resistant to what drug/s?

A

fluoroquinolones and any second line TB injectable drugs (amikacin, kanamycin, capreomycin)

27
Q

What is the most important risk factor for MDR TB?

A. known contact with person proven with MDR TB
B. prior TB treatment
C. treated in program outside DOTS
D. sputum smear (+) at 2 months of treatment
E. co-morbidities (e.g. HIV)

A

B. any prior TB treatment

28
Q

T/F: EPTB is usually less infectious than PTB.

A

T

29
Q

T/F: There are more percent EPTB cases in PGH.

A

T

30
Q

The most common site of EPTB

A. pleural
B. lymphatic
C. musculoskeletal
D. genitourinary
E. miliary
A

B. lymphatic

31
Q

ID: Most fatal EPTB.

A

meningeal TB

32
Q

Dr. Berba: What is the clinical implication of EPTB?

A. The Mycobacteria causing EPTB syndromes are usually resistant and more difficult to treat.
B. The Mycobacteria causing EPTB are usually more virulent so mortality rates are higher.
C. EPTB is less infectious and thus less a public health concern.
D. All EPTB should be treated for at least 12 months.

A

C. less infectious

33
Q

Dr. Berba: What is the best practice to establish diagnosis of EPTB?

A. sputum AFB
B. tissue/fluid AFB smear and TB culture
C. tissue/fluid AFB, TB culture, and histopathology
D. serological tests for TB

A

C

34
Q

What is the best practice of treatment for newly-diagnosed pleural EPTB?

A. 2HRZE/4HR
B. 2HRZE/4HRE
C. 2HRZ/4HRE
D. 2HRZE/6HE

A

A. same with PTB

35
Q

Which EPTB are treated for more than 6 months?

A

CNS and MSK TB

36
Q

True of TB lymphadenitis EXCEPT

A. peak age shifted from children to 20-40 y/o
B. Asians are among high risk groups
C. involves neck lymph nodes
D. with numerous pulmonary calcifications

A

D. LITTLE / FEW pulmonary calcifications

37
Q

ID: TB lymphadenitis in the neck is more commonly known as what?

A

scrofula

38
Q

T/F: Surgical incision and drainage of scrofula is recommended.

A

F

Did not say why.

39
Q

Most common site of musculoskeletal TB

A. lumbar vertebrae
B. thoracic vertebrae
C. knee
D. hip
E. muscle
A

A. lumbar vertebrae

prevalence in same order as choices

40
Q

Tuberculous spondylitis is also known as

A

Pott’s disease

41
Q

True of TB osteomyelitis EXCEPT

A. painful
B. prefers diaphysis
C. single in adults
D. may extend to joint

A

B

It prefers METAPHYSIS

42
Q

Most common sign and symptom of genitourinary tuberculosis.

A. microscopic hematuria
B. sterile pyuria
C. suprapubic pain
D. urine pus cells
E. testicular swelling
A

B. sterile pyuria

painless frequent micturition is also common

43
Q

T/F: Steroids may be used in TB pericarditis.

A

T.

to dampen the inflammatory process

44
Q

Most common site of gastrointestinal TB

A. spleen
B. liver
C. stomach
D. small intestine

A

B. liver

45
Q

Cutaneous TB resulting from an endogenous source

A. tuberculous chancre
B. prosector’s wart
C. scrofuloderma
D. lupus vulgaris

A

C. scrofuloderma

A & B are exogenous
D is hematogenous

46
Q

ID: Predilection (location) of tuberculous meningitis.

A

base of the brain (high oxygen)

47
Q

True of CSF analysis in CNS TB EXCEPT.

A. elevated protein
B. elevated glucose
C. clear or slightly opalescent
D. may be (+) AFB

A

B.

There is LOW glucose.

48
Q

T/F: Steroids may be used in TB meningitis.

A

T

also true for TB pericarditis

49
Q

A previously treated drug-susceptible TB with CNS involvement (TB meningitis) is classified as

A. Category I
B. Category Ia
C. Category II
D. Category IIa
E. Category III
A

D. IIa

walang A = walang CNS or MSK involvement
cat II = previously treated
cat III = wala neto

50
Q

MDR-TB is treated for at least how many months?

A

18 months

OS 217 Infectious Diseases (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions