TB

Question 1

Bacteria that causes TB

Answer 1

Mycobacterium tuberculosis

Question 2

Which type of TB is infectious?

Answer 2

pulmonary

Question 3

Describe the natural history of TB

Answer 3

1) TB spread by coughing
2) 1y infection
3) immune clearance
4) establishment of latent infection
5) reactivation of TB causing disease
6) Back to 1

Question 4

what is the incubation period of TB?

Answer 4

3-9 months, unusual after 2 years

Question 5

when are granulomas formed- what stage of infection?

Answer 5

in the adaptive immune phase of containment

Question 6

5 symptoms of TB

Answer 6

cough (2-3 weeks or longer)
fevers
unexplained weight loss
drenching night sweats
lymphadenopathy

Question 7

3 key features to look out for on a hx

Answer 7

hx of prior TB infection
known or possible TB exposure
current/past residence or travel to an endemic country

Question 8

what does miliary TB indicate?

Answer 8

haematogenous spread

Question 9

what is the cheapest test for TB?

Answer 9

staining for acid and alcohol fast bacilli (AAFB)

Question 10

2 types of microscopy used to diagnose TB

Answer 10

Light

fluorescence

Question 11

What is the sensitivity of sputum cultures for TB?

Answer 11

80%

Question 12

What is the specificity of sputum cultures for TB?

Answer 12

98%

Question 13

why is culture necessary in TB diagnosis?

Answer 13

vital for drug susceptibility testing and species identification

Question 14

What rapid test can be used for TB diagnosis?

Answer 14

nucleic acid amplification tests

Question 15

what test for diagnosis of TB can be used in HIV patients?

Answer 15

urine antigen test- detects mycobacterial cell wall glycolipid lipoarabinomannan (urine LAM)

Question 16

Treatment of TB

Answer 16

2 months RIPE-
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol

followed by 4 months of isoniazid and rifampicin

Question 17

Why are people with HIV so susceptible to TB? (5)

Answer 17

• HIV promotes reactivation of latent TB
• HIV impairs containment of TB
• Accelerates TB pathology
• TB promotes immune activation which enables HIV to infect more CD4 cells
• HIV impairs granuloma formation

Question 18

10 aspects of the NHS TB strategy for 2015-2020

Answer 18

• improving access to services and ensuring early diagnosis
• providing universal access to high quality diagnostics
• improving treatment and care services
• ensuring comprehensive contact tracing
• improving BCG vaccination uptake
• reducing drug-resistant TB
• tackling TB in under-served populations
• systematically implementing new entrant latent TB screening
• strengthening surveillance monitoring and;
• ensuring an appropriate workforce to deliver TB control.

Question 19

what was the first anti-Tb drug?

Answer 19

streptomycin

Question 20

what is directly observed treatment?

Answer 20

initiated for those who are unable to adhere to tx. professional case worker, person trained to be a DOT observer, or a trusted family member or friend will watch the patient take their TB treatment.

Question 21

key stage of TB mx for public health?

Answer 21

contact tracing

Question 22

how many sputum samples should you send for analysis?

Answer 22

3