Pulmonary Tuberculosis

Question 1

In primary TB, the initial infection with tubercle bacilli is called ___

Answer 1

Ghon Focus

Question 2

Primary TB is often seen in

Answer 2

Children

Question 3

Ghon focus is usually seen in what part of the lungs

Answer 3

Middle and lower lung zones

Question 4

Post-primary TB is often seen in what part of the lungs

Answer 4

1. Apical and posterior segments of the upper lobe

2. Superior segments of lower lobes

Question 5

In diagnosing presumptive TB, the cut-off age to be considered as adult is ___

Answer 5

15 years old

Question 6

What are the criteria of Presumptive TB

Answer 6

1. Cough at least 2 weeks
2. Unexplained cough of any duration in a close contact of a known active TB case
3. CXR suggestive of PTB with or without symptoms

Question 7

What is the most common etiology of hemoptysis worldwide?

Answer 7

TB

Question 8

What are the most common cause of hemoptysis in industrialized countries/

Answer 8

Bronchitis

Bronchiectasis

Question 9

Massive hemoptysis is defined as blood loss of ___

Answer 9

1. 400mL in 24 hours

2. 100 to 150 mL expectoration at one time

Question 10

The primary diagnostic method to bacteriologically confrm TB is

Answer 10

Direct sputum smear microscopy

Question 11

How will you conduct DSSM?

Answer 11

Same day Spot-spot strategy 1 hour apart, at least 5mL

At least one is positive

Question 12

What is the best initial test to diagnose TB?

Answer 12

Gene X-pert MTB/RIF at least 1mL

Question 13

What is the preferred screening test for latent TB infection in a resource limited setting?

Answer 13

TST

Alternative is IGRA

Question 14

[TB Regimen]

New Pulmonary TB

Answer 14

2HRZE = 2 RIZE
4HR = 4 RI

Question 15

[TB Regimen]

New miliary TB

Answer 15

2HRZE = 2 RIZE
4HR = 4 RI

Question 16

[TB Regimen]

New EPTB except CNS, Bones, Joints

Answer 16

2HRZE = 2 RIZE
4HR = 4 RI

Question 17

[TB Regimen]

EPTB CNS, Bones, joints

Answer 17

2HRZE = 2 RIZE
10HR = 10 RI

Question 18

[TB Regimen]

Retreatment of rifampicin susceptible PTB and EPTB

except CNS, bones, joints

Answer 18

2HRZES = 2 RIZES
1HRZE = 1 RIZE
5HRE = 5 RIE

Question 19

[TB Regimen]

Retreatment of Rifampicin susceptible CNS, Bones, Joints TB

Answer 19

2HRZES = 2 RIZES
1HRZE = 1 RIZE
9HRE = 9 RIE

Question 20

[TB Regimen]

Dosing of isoniazid

Answer 20

5mg/kg

Question 21

[TB Regimen]

Dosing of Rifampicin

Answer 21

10mg/kg

Question 22

[TB Regimen]

Dosing of Ethambutol

Answer 22

15mg/kg

Question 23

[TB Regimen]

Dosing of Streptomycin

Answer 23

15mg/kg

Question 24

[TB Regimen]

Dosing of pyrazinamide

Answer 24

25mg/kg

Remember: HREZ 5 10 15 25

Question 25

[TB Regimen]

most hepatotoxic

Answer 25

Pyrazinamide

Question 26

[TB Regimen]

peripheral neuropathy

Answer 26

Isoniazid

inhibit mycolic acid synthesis

Give B6

Question 27

[TB Regimen]

Optic neuritis, decreased color perception

Answer 27

Ethambutol

inhibit arabinosyltransferase

Question 28

[TB Regimen]

Asymptomatic hyperuricemia

Answer 28

Pryazinamide

Question 29

[TB Regimen]

Autoimmune thrombocytopenia

Answer 29

Rifampicin

Blocks DNA-dependent RNA polymerase, most active

Question 30

Most common EPTB

Answer 30

TB lymphadenitis

Question 31

Most common location of skeletal TB

Answer 31

Thoracic and upper tumbar

Question 32

What is the cornerstone in diagnosing TB meningitis?

Answer 32

Lumbar puncture

Question 33

[TB Regimen]

MOA of streptomycin

Answer 33

binds at 30s