TB

Question 1

Highest rates of active TB occur in Africa (363 cases per 100 000) and Asia (180 cases per 100 000)

Answer 1

By 1994, 20 healthcare personnel had acquired multidrug resistant TB; 45 % of them died.

Question 2

Why did US rates in US decrease in 2011?

Answer 2

Implementation of expanded treatment regimens, increasing coverage of DOT, (including involuntary detention and administration of therapy when needed), and implementation of CDC recommended infection control recommendations.

Question 3

M. Tuberculosis, is an aerobic, acid fast bacillus
People are primarily infected by inhalation
NonTB Mycobacteriua can cause a varity of disease, including pulmonary, skin, and soft tissue infections, especially in immunocompromised individuals.

Question 4

Testing
TB stain ZN (Ziehl Neelsen)
MTB is an aerobic, poorly staining gram-positive bacillus. like other mycobacteria, it is acid fast, meaning that certain stains, such as kinyoun or ziehl-neelsen, will not decolorize with acid- alcohol.

Question 5

Prevention of TB

How many air exchanges for negative pressure?

Answer 5

Based on detection of cases
airborne isolation in appropriate negative pressure rooms
respiratory etiquette
Use of N95 respirators
Early and complete treatment of TB cases based on susceptibility testing

At least 12 air exchanges

Question 6

How long for PPD to become positive?

Answer 6

8-12 weeks to come positive following exposure

Question 7

The optimal time to collect a sputum specimen for an acid-fast bacilli (AFB) testing to rule out TB would be:
a. first thing in the morning
b. after respiratory treatment
c. prior to the patient going to bed
d. prior to respiratory treatment

Answer 7

a.

Question 8

The validity of a culture report is dependent on the quality of the specimen sent. To determine if an expectorated specimen was sputum and not saliva, the gram stain should show:
a. more than 10 epithelial cell per low-power field and abundant pseudomonas aeruginosa in pure culture
b. more than 10 epithelial cells per low-power field and moderate to abundant polys.
c. many WBCs and organisms on low-power field
d. fewer than 10 epithelial cells per low-power field

Answer 8

D. epithelial cells line the mouth-indicating saliva.