PPS TB Guidelines

Question 1

True or False: (XPERT MTB/RIF Assay)

Rifampicin resistance can be used to represent multidrug resistance

Answer 1

True

page 26

Question 2

when is Tuberculin skin testing is utilized?

Answer 2

> to help in decision-making for preventive chemotherapy in young children
to identify individuals who are at increased risk for the development of active TB
to determine a sentinel event, reflecting recent TB transmission

page 82

Question 3

The proper procedure on performing tuberculin skin test includes…

Answer 3

A pale wheal of 6-10mm in diameter must be evident after injection

Question 4

What is commonly seen in the radiographic changes in primary TB

Answer 4

> parenchymal involvement (primary focus)
Pleural effusion
Lymphadenitis
Lymphangitis

Question 5

radiologic changes in childhood TB

Answer 5

> In the first 3 months of treatment, worsening of radiographic findings may still be observed

page 100

Question 6

True regarding airway involvement in PTB

Answer 6

> It is usually the result of bronchi compression due to enlarged lymph nodes
Hyperaeration may occur in a segment, lobe or entire lung
Tuberculous lymph nodes may cause obstruction by compression or ulceration into the airways

Question 7

TRUE regarding TB Osteomyelitis

Answer 7

> Usually hematogenous in origin
Commonly seen in the long bones of the extremities and small bones of the hands and feet
In children, involvement of the growth plate may occur

Question 8

most specific finding in CT Scan suggestive of TB Meningitis

Answer 8

basal cistern hyperdensity

Question 9

Recommendations in the management of TB in children

Answer 9

> Older children and adolescents should be treated at adult dosages once they reach a BW of 25kgs
maxiumum dose of Rifampicin is 600mg/day
Co-administration of INH and RIF with VItamin C inactivate suspensions
The minimum effective dose of Isoniazid is 7mg/kg

Question 10

Treatment category after Lost to Follow-up is considered

Answer 10

Cat II (page 151)

Question 11

Treatment regimen for Category IA

Answer 11

2HRZE/10HR

Question 12

dose for corticosteroid as adjunct in the management of TB in children,

Answer 12

Prednisone 1-2 mg/kg over 4-6 weeks with gradual tapering (page 157)

Question 13

Management of a newborn whose mother has LTBI

Answer 13

the infant should be given BCG (page 178)

Question 14

Management of a newborn with TB symptomatic mother should include the following

Answer 14

> The well newborn should receive IPT for 3 months
Separation is recommended for a mother who currently has TB Disease and has not received treatment
If the infant has a positive tuberculin skin test after 3 months of INH, continue IPT for another 3 months

Question 15

Drug-induced Hepatitis during anti-TB chemotherapy

Answer 15

> Drug-induced liver injury is defined as AST >3x ULN with symptoms
Drug-induced liver injury is defined as AST >5x ULN with or without symptoms
Anti-TB chemotherapy may be retarted one at a time once AST level returns <2x ULN
Rifampicin should be restarted first as it is the least hepatotoxic