TB Fitz

Question 1

53. You examine a 28-year-old woman who has emigrated from a country where tuberculosis (TB) is endemic. She has documentation of receiving Bacille Calmette-Guérin (BCG) vaccine as a child. With this information, you consider that:
    A. she will always have a positive tuberculin skin test
    (TST) result.
    B. biannual chest radiographs are needed to assess her health status accurately.
    C. a TST finding of 10 mm or more induration should
    be considered a positive result.
    D. isoniazid therapy should be given for 6 months
    before TST is undertaken.

Answer 1

C. a TST finding of 10 mm or more induration should

be considered a positive result.

Question 2

54. A 33-year-old woman works in a small office with a
    man recently diagnosed with active pulmonary TB.
    Which of the following would be the best plan of care
    for this woman?
    A. She should receive TB chemoprophylaxis if her TST
    result is 5 mm or more in induration.
    B. Because of her age, TB chemoprophylaxis is contraindicated even in the presence of a positive TST
    result.
    C. If the TST result is positive but the chest radiograph
    is normal, no further evaluation or treatment is
    needed.
    D. Further evaluation is needed only if the TST result is
    15 mm or more in induration.

Answer 2

A. She should receive TB chemoprophylaxis if her TST

result is 5 mm or more in induration.

Question 3

55. Compared with TST, potential advantages of the
    QuantiFERON®-TB Gold test (QTF-G) include all
    of the following except:
    A. the ability to have the entire testing process
    complete with one clinical visit.
    B. the results are available within 24 hours.
    C. the interpretation of the test is not subject to
    reader bias.
    D. it is able to predict who is at greatest risk for active
    disease development.

Answer 3

D. it is able to predict who is at greatest risk for active

disease development.

Question 4

56 to 60. For the following individuals, answer yes or no in response to the question, “Does this patient
have a reactive TST?”

56. a 45-year-old woman with type 2 diabetes mellitus
    and chest radiograph finding consistent with
    previous TB and a 7-mm induration

Yes or No

Answer 4

Yes

Question 5

56 to 60. For the following individuals, answer yes or no in response to the question, “Does this patient
have a reactive TST?”

57. a 21-year-old man with no identifiable TB risk
    factors and a 10-mm indurat

Yes or No

Answer 5

No

Question 6

56 to 60. For the following individuals, answer yes or no in response to the question, “Does this patient
have a reactive TST?”

58. a 31-year-old man with HIV and a 6-mm induration

Yes or No

Answer 6

Yes

Question 7

56 to 60. For the following individuals, answer yes or no in response to the question, “Does this patient
have a reactive TST?”

59. a 45-year-old woman from a country in which TB
    is endemic who has an 11-mm induration

Yes or No

Answer 7

Yes

Question 8

56 to 60. For the following individuals, answer yes or no in response to the question, “Does this patient
have a reactive TST?”

60. a 42-year-old woman with rheumatoid arthritis
    who is taking etanercept (Enbrel®) who has a
    7-mm induration

Yes or No

Answer 8

Yes

Question 9

61. Risk factors for development of infection reactivation in patients with latent TB infection include all of the following except:
    A. diabetes mellitus.
    B. immunocompromise.
    C. long-term oral corticosteroid therapy.
    D. male gender.

Answer 9

D. male gender.

Question 10

62. Clinical presentation of progressive primary TB most commonly includes all of the following except:
A. malaise.
B. fever.
C. dry cough.
D. frank hemoptysis.

Answer 10

D. frank hemoptysis.