TB, HIV, and Hepatitis

Question 1

Is latent TB infectious?

Answer 1

No

Question 2

How often does latent TB develop into active TB?

Answer 2

10%

Question 3

What is military TB?

Answer 3

Carried to all parts of the body

Question 4

Who is at risk for TB?

Answer 4

Immunocompromised: DM, HIV, cancer, DM, renal failure, steroid therapy, debilitative state
Close contact: boarding schools, homeless shelters

Question 5

Where is TB seen on CXR?

Answer 5

Upper lobes

Question 6

Signs and symptoms of TB?

Answer 6

Cough, fever, weight loss, lethargy, anorexia, night sweats, cough, chest pain, hemoptysis

Question 7

What is the only diagnostic test for TB?

Answer 7

sputum test

Question 8

When should you test for resistance for TB, and what is defined as resistance?

Answer 8

Always, Drug resistant is resistant to one drug, while multi drug resistant is resistant to more than one drug

Question 9

How do you check the TST?

Answer 9

Based solely on induration, not erythema

Question 10

DD for TB?

Answer 10

Penumonia, pneumoitis, neoplasm, fungal infection, sarcoidosis, pulmonary fibrosis

Question 11

What do you monitor for Isoniazid?

Answer 11

liver function and peripheral neuropathy. Can cause dark urine

Question 12

What will occur with rifampin?

Answer 12

Dark urine

Question 13

Side effects of pyrazinamide?

Answer 13

GI, myalgia, and arthralgia

Question 14

What do you do for Ethambutol?

Answer 14

baseline eye exam, visual acuity and color vision, CBC and CNS

Question 15

What’s the preferred therapy for TB?

Answer 15

Direct observation therapy for drug resistant, intermittent therapy, and risk for non adherence

Question 16

Functions of the liver?

Answer 16

Bile, eliminiates biliruben, metabolizes hormones and drugs, syntehsizes proteins, glucose storage, stores minerals and vitamins, converts ammonia to urea, converts fatty acids to ketones, filters the blood for metabolites and bacteria

Question 17

Different causes of acute hepatitis?

Answer 17

Autoimmune, drugs, toxins, infections (bacteria, virsuses)

Question 18

How are the different forms of viral hepatitis separated?

Answer 18

Only by serology

Question 19

Three stages of hepatitis?

Answer 19

Prodromal, icteric, convalescent

Question 20

Hep A transmission?

Answer 20

Fecal oral route

Question 21

DD for hepatitis A?

Answer 21

Mono, cancer, obstructive jaundice, ETOH hepatitis or cirrhosis, liver injury, food poisoning, HIV acute, CMV

Question 22

How do you test for Hep A

Answer 22

IgM and IgG

Question 23

How do you transmit hep b?

Answer 23

blood or body fluids

Question 24

How often does Hep B become chronic?

Answer 24

6-10%,

Question 25

Labs for evaluation of Hep B?

Answer 25

HIV, GGT, genotype and viral load, serum iron, liver panel, abdominal imaging

Question 26

Nomenclature for Hepatitis?

Answer 26

``` E- envolope- center C- core- middle S- surface, outside Ag- antigen from virus Ab- antibody from host ```

Question 27

HBeAg?

Answer 27

active viral repilation

Question 28

HBcAb?

Answer 28

Previous exposure

Question 29

HBsAb?

Answer 29

Immunity

Question 30

HBsAg?

Answer 30

Persistant virus

Question 31

How do you treat HBV?

Answer 31

With GI MD. Most important carcinogen after tobacco.

Question 32

Treatment for HBV exposure?

Answer 32

HB IG within 48 hours

Question 33

Who get's immunized?

Answer 33

MSM, all infants

Question 34

How is Hep C contracted?

Answer 34

Primarily through infected blood

Question 35

Incubation for hepatitis C?

Answer 35

14-180 days, with average of 45 days

Question 36

Who develops symptoms and percentage that develop into chronic HCV?

Answer 36

20-30 develop acute symptoms, and 70-85% develop chronic HCV

Question 37

Labs for HCV?

Answer 37

AntiHCV, HCV RNA PCR, genotyping, LFTs, ETOH, CBC, pregnancy test, TSH, A1C

Question 38

Who do you screen for HCV?

Answer 38

Born 1945-1965, IVDU, recipient of clotting factors before 1987, HD

Question 39

Shortest timeline treatment for active TB? Usually length of treatment?

Answer 39

6 months is shortest treatment | 9 months is usual treatment

Question 40

Test results for >5 mm, >10 mm, and >15 mm

Answer 40

>5- HIV, immunocompromised, transplant, CXR healed TB >10- foreigners, medically underserved, IVDU, risk factors, all other medical conditions that could predispose somebody like DM, cancer, gastric surgery >15 all other person

Question 41

Who should receive hepatitis a vaccine?

Answer 41

Recent infection, acute infection, children, MSM, IVDU, occupational risk, clotting disorder

Question 42

treatment for hepatitis A?

Answer 42

usually self limiting, can do IgG within two weeks

Question 43

Treatment for hepatitis B?

Answer 43

Only do medications for chronic hepatitis B virus.

Question 44

Chronicity rate for hepatitis B?

Answer 44

5-10%

Question 45

Treatment cure for HCV?

Answer 45

Sustained virology response for 24 weeks after then end of treatment

Question 46

What should you do for people with hepatitis ABC?

Answer 46

Screen for alcoholism and cessation?

Question 47

How long is Genotype 1 treated for HCV and Genotype 2, 3, and 4

Answer 47

Genotype 1 is 48 weeks | Genotype 2, 3, and 4 is 24 weeks

Question 48

Most common cause of ALT and AST?

Answer 48

Fatty liver

Question 49

What does HBeAG and HBsAg suggest

Answer 49

Infected HBeAg- active viral replication HBsAg- persistant virus

Question 50

What does IgM anti HBc suggest?

Answer 50

Acute infection

Question 51

What does HBcAb suggest?

Answer 51

Pervious exposure

Question 52

What does HBsAb suggest?

Answer 52

Immunity