tuberculosis

Question 1

LTBI treatment

Answer 1

isoniazid PO 5mg/kg OD max 300mg/day x 6m or 9m (HIV) + pyridoxine (≥ 10mg/day)
rifampicin PO 10mg/kg OD max 600mg x 4m
isoniazid plus rifapentine PO 900mg weekly x 12w

Question 2

ATBI treatment

Answer 2

RIF PO 10mg/kg/day OR 10mg/kg 3x/w 
INH PO 5mg/kd/day max 300mg OR 15mg/kg 3x/w max 900mg
PZA* PO 15-30mg/kg/day max 2g/day 
EMB* PO 15-25mg/kg/day max 1600mg/day
STM* IM 10-15mg/kg/day max 1g/day

Question 3

standard treatment w PZA

Answer 3

2m intensive phase, daily RIF, INH, PZA, EMB/STM

4m continuation phase, daily or 3x/w RIF, INH

Question 4

standard w/o PZA treatment

Answer 4

2m intensive phase, daily RIF, INH, EMB

7m continuation phase, daily OR 3x/w RIF, INH

Question 5

hepatotoxicity risk factors in TB

Answer 5

> 35y 
female 
underlying liver disease 
concurrent alcohol use 
HIV

Question 6

diagnosis of active TB

Answer 6

suspicions based on history, risk factors, clinical presentation, physical exam findings, chest x ray findings
treatment initiated with sputum acid fast stain positive

Question 7

diagnosis of latent TB

Answer 7

tuberculin skin test (≥ 10mm)

interferon-gamma release assay

Question 8

indication for LTBI screening

Answer 8

high risk with intent to treat if positive

• children with recent TB contact
• HIV infected
• patients considered for TNFa therapy
• transplant patients
• dialysis patients

Question 9

LFT monitoring in TB patients

Answer 9

≥ 1 risk factor

baseline LFT and every 2-4w during treatment

Question 10

visual toxicity monitoring in TB patients

Answer 10

baseline monitoring for all patients
monthly monitoring for patients
- taking EBM for more than 2m
- with renal insufficiency