TB

Question 1

How do you confirm the diagnosis of ACTIVE TB?

Answer 1

First, you’ll have a positive TST or IGRA response then you get a CXR–> if cavitation is present then ACTIVE TB is present

Question 2

Clinical presentation of active TB

Answer 2

weight loss, malaise, hemoptysis, night sweats, productive cough

Question 3

What are the main risk factors for developing TB?

Answer 3

household exposure, incarceration, drug use, travel to endemic areas

Question 4

What lab test is best for diagnosing TB?

Answer 4

sputum CULTURE is preferred over sputum smear; a smear can give false positive due to flora of upper airway;

Question 5

How do you obtain a sputum culture?

Answer 5

3 consecutive mornings in a row

Question 6

What is the therapy of choice for active TB?

Answer 6

Isoniazid, rifampin, ethambutol, pyrazinamide for 6-9 months

Question 7

True or False: Treatment for active TB can be discontinued once TB is clinically gone

Answer 7

false

Question 8

What routine tests do patients on the four drug regiment need?

Answer 8

LFT’s

Question 9

Contraindicated in pregnancy

Answer 9

pyrazinamide

Question 10

Increased risk for gout

Answer 10

pyrazinamide

Question 11

diminished visual acuity and requires frequent eye exams

Answer 11

ethambutol; loss of ability to distinguish between red and gree

Question 12

can cause peripheral neuritis

Answer 12

isoniazid (supplement with vit B6)

Question 13

Should take with supplemental B6

Answer 13

Isoniazid

Question 14

Can cause hepatitis and death

Answer 14

isoniazid (and to an extent rifampin)

Question 15

Decrease half life of oral contraceptives, prednisone, coumadin

Answer 15

rifampin

Question 16

9 months of isoniazid is recommended for what form of TB?

Answer 16

latent

Question 17

This form of TB is associated with milary pattern on cxr

Answer 17

disseminated

Question 18

Would you expect someone with a previous BCG shot to have a positive or negative TST ?

Answer 18

false positive; if positive with prior BCG vaccine an xray is indicated

Question 19

When do you get both a TST and a IGRA?

Answer 19

never! Don’t do both

Question 20

Should people with prior BCG receive a TST or IGRA test?

Answer 20

IGRA