TB

Question 1

What are the high-risk indications for TB testing?

Answer 1

Individuals at high risk of TB exposure or infection.

Question 2

What are the TB diagnostic tests?

Answer 2

IGRA (Interferon Gamma Release Assay), TB Skin Test (TST/PPD), Chest X-ray, Sputum culture.

Question 3

What vaccine is used for TB prevention?

Answer 3

BCG (Bacille Calmette-Guérin).

Question 4

What should be used if a false-positive TST is suspected?

Answer 4

IGRA test.

Question 5

Why is TB treatment long-term?

Answer 5

TB bacteria grow slowly, require prolonged exposure to antibiotics to be fully eradicated.

Question 6

What are the risks of TB treatment?

Answer 6

Toxicity, poor adherence, and drug resistance.

Question 7

How many drugs are used for active TB treatment?

Answer 7

Always at least 2 drugs.

Question 8

What are the primary drugs for active TB treatment?

Answer 8

Isoniazid (INH) & Rifampin.

Question 9

What is Directly Observed Therapy (DOT)?

Answer 9

A strategy where healthcare workers ensure medication intake, given at least 5 out of 7 days per week.

Question 10

What is Self-Administered Therapy (SAT)?

Answer 10

TB treatment without supervision.

Question 11

How long is the intensive phase of TB treatment?

Answer 11

8 weeks.

Question 12

Which drugs are included in the 6- or 9-month regimen’s intensive phase?

Answer 12

Isoniazid + Rifampin + Pyrazinamide + Ethambutol.

Question 13

Which drugs are included in the 4-month regimen’s intensive phase?

Answer 13

Isoniazid + Rifapentine + Pyrazinamide + Moxifloxacin.

Question 14

How long is the continuation phase of TB treatment for the 6-/9-month regimen?

Answer 14

18-31 weeks (total treatment: 26-39 weeks).

Question 15

Which drugs are used in the continuation phase of the 6-/9-month regimen?

Answer 15

Isoniazid + Rifampin.

Question 16

How long is the continuation phase of the 4-month regimen?

Answer 16

9 weeks (total treatment: 17 weeks).

Question 17

Which drugs are used in the continuation phase of the 4-month regimen?

Answer 17

Isoniazid + Rifapentine + Moxifloxacin.

Question 18

What are the three preferred regimens for latent TB treatment?

Answer 18

1) Isoniazid + Rifapentine weekly for 3 months, 2) Rifampin daily for 4 months, 3) Isoniazid + Rifampin daily for 3 months.

Question 19

What are the optional latent TB treatment regimens?

Answer 19

Isoniazid daily for 6-9 months (DOT or SAT), Isoniazid twice weekly for 6-9 months (DOT).

Question 20

What is the primary agent for TB treatment and prevention?

Answer 20

Isoniazid (INH).

Question 21

What are the major adverse effects of INH?

Answer 21

Peripheral neuropathy, hepatotoxicity, CNS effects, GI upset, dry mouth, urinary retention.

Question 22

What is always given with INH to prevent neuropathy?

Answer 22

Pyridoxine (Vitamin B6) 50-200mg/day.

Question 23

What are the symptoms of INH hepatotoxicity?

Answer 23

Anorexia, malaise, fatigue, nausea, jaundice.

Question 24

What should be monitored in patients taking INH?

Answer 24

Liver function tests (LFTs).

Question 25

What CNS effects can INH cause?

Answer 25

Optic neuritis, seizure, dizziness, ataxia, depression, agitation, memory impairment, hallucinations, psychosis.

Question 26

What are the drug interactions of INH?

Answer 26

CYP450 inhibitor; increases phenytoin levels.

Question 27

How should INH be taken?

Answer 27

1 hour before or 2 hours after a meal with a full glass of water.

Question 28

What is the main counseling point for Rifampin and Rifapentine?

Answer 28

Take on an empty stomach.

Question 29

What are the major adverse effects of Rifampin and Rifapentine?

Answer 29

Hepatotoxicity, discoloration of body fluids, GI effects, skin reactions, rare flu-like symptoms.

Question 30

What are the drug interactions of Rifampin and Rifapentine?

Answer 30

Potent CYP450 inducer (reduces effectiveness of many drugs).

Question 31

What are the adverse effects of Pyrazinamide?

Answer 31

Hepatotoxicity, polyarthralgias, GI upset, rash, photosensitivity with dermatitis.

Question 32

What should be avoided with Pyrazinamide?

Answer 32

Alcohol and tyramine-containing foods.

Question 33

What are the adverse effects of Ethambutol?

Answer 33

Optic neuritis, allergic reactions, GI upset, confusion, rare peripheral neuropathy, renal damage, thrombocytopenia.

Question 34

How is TB treatment monitored for effectiveness?

Answer 34

Sputum culture, chest X-ray, and clinical evaluation.

Question 35

How often is a sputum culture performed?

Answer 35

Monthly until 2 consecutive specimens are negative.

Question 36

When should a repeat chest X-ray be done?

Answer 36

After 2 months of treatment.

Question 37

What clinical symptoms should be monitored during TB treatment?

Answer 37

Fever, malaise, anorexia, and cough at every clinic visit.