Specimens

Question 1

• Throat swabs
• Nasopharyngeal swabs
• Throat washings
• Sputum
• Tracheal and transtracheal aspirate
• Bronchoscopy, BAL, and lung tissue specimens

Answer 1

M. pneumoniae

Question 2

• Tissue fluid expressed from ulcers and lesions for microscopy
• Blood (serum) or CSF for serologic testing
• A small section of umbilical cord for testing congenital syphilis

Answer 2

Treponema pallidum

Question 3

• sputum
• tracheal aspirate
• endotracheal aspirate
• bronchial washing
• bronchial alveolar lavage fluid
• nasopharyngeal aspirate
• gastric aspirate
• CSF
• peritoneal, synovial fluid
• tissues and fine needle aspiration biopsy specimens

Answer 3

Specimens for Xpert MTB/RIF test

Question 4

Other fluid aspirates and biopsy specimens can only be submitted to specifically designated
laboratories equipped with certified biosafety cabinets such as in

Answer 4

TB culture laboratories

Question 5

are currently not accepted specimens for Xpert MTB/RIF testing

Answer 5

Blood, urine and stools

Question 6

MTB detected; rifampicin resistance not detected

Answer 6

T

Question 7

MTB detected; rifampicin resistance detected

Answer 7

RR

Question 8

MTB detected; rifampicin resistance indeterminate

Answer 8

TI

Question 9

MTB not detected

Answer 9

N

Question 10

Invalid/no result/error

Answer 10

I

Question 11

It is a manual molecular assay to detect MTBC based on LAMP (loop-mediated
isothermal amplification) techniques, a unique temperature-independent
technique for amplifying DNA. It requires less than 1 hour to perform and can be
read with the naked eye under ultraviolet light.

Answer 11

TB LAMP (Eiken Chemical, Japan)

Question 12

It can replace smear microscopy, especially in remote areas

Answer 12

TB LAMP (Eiken Chemical, Japan)

Question 13

it cannot detect rifampicin resistance and there is limited evidence of performance in comparison to Xpert MTB/RIF in children and people living with HIV (PLHIV) who have more smear negative pulmonary TB

Answer 13

TB LAMP (Eiken Chemical, Japan)

Question 14

workflow for TB LAMP

Answer 14

• sample preparation
• DNA extraction (PURE)
• Amplification (LAMP reaction)
• Detection

Question 15

It is family of DNA strip-based tests that determine the drug resistance profile of
a MTBC through the pattern of binding of amplicons (DNA amplification products) to probes targeting the most common resistance associated mutations to first- and second-line agents

Answer 15

Line Probe Assay (LPA)

Question 16

Line Probe Assay (LPA) is used for rapid detection of drug resistance to

Answer 16

rifampicin and isoniazid

Question 17

LPA is recommended for:

• direct testing of [?]
  specimens (direct testing)
• a [?] of MTBC
  (indirect testing).

Answer 17

smear-positive; cultured isolate

Question 18

This refers to the staining of AFB in direct smears of unconcentrated sputum specimen

Answer 18

Direct Sputum Smear Microscopy (DSSM)

Question 19

DSSM It can be performed either by

Answer 19

brightfield microscopy or fluorescence

microscopy

Question 20

DSSM serves as a basis for the diagnosis of TB cases. This is also used:
a. to [?] of patients with TB while they are on anti-TB
treatment; and,
b. [?] at the end of treatment in drug-sensitive TB cases.

Answer 20

monitor progress; confirm cure