Tuberculosis

Question 1

reactivation of latent tuberculosis is responsible for ________how much_____ of active tuberculosis cases

Answer 1

70%

Question 2

Patients With a High Prevalence of Tuberculosis (Highest to Lowest Risk)

Answer 2

• IMMIGRANTS from high-prevalence countries
• HIV
• PRISONERS or shelters for the homeless
• ALCOHOLICS/ DRUGS users
• ELDERLY and nursing home patients

Question 3

IDENTIFY

Answer 3

Primary Ghon complex (arrow)

is a tubercle, appearing as calcified hilar lymph nodes.

Question 4

The tendency is for survival in areas of high oxygen content or blood flow, such as the

Answer 4

1. apical and posterior segments of the upper lobe and the superior segment of the lower lobe of the lung,
2. renal cortex
3. meninges
4. epiphyses of long bones
5. vertebrae

Question 5

During dormancy (or latent infection), _______________ detects the disease

Answer 5

a positive tuberculin skin test

Question 6

The tuberculin skin test becomes positive ____________ after initial exposure

Answer 6

1 to 2 months

Question 7

True or false

Latent infection is not transmissible.

Answer 7

True

Question 8

The risk for reactivation is higher among ____________ and those over ________ old.

Answer 8

HIV-infected

Over 50 years

Question 9

Population with increased risk for tuberculosis activation

Answer 9

> immunocompromised from cancer of solid organs,
leukemia
transplantation
medications
Antagonists of tumor necrosis factor-α (etanercept or infliximab)
corticosteroids (≥15 milligrams/d for ≥4 weeks of prednisone or its equivalent)
chronic diseases such as
diabetes
chronic renal failure requiring hemodialysis
psoriasis
silicosis

Question 10

most common extrapulmonary site of tuberculosis is the

Answer 10

lymphatic system—painless lymphadenopathy (i.e., scrofula, cervical lymphadenitis)

Question 11

On chest radiograph, look carefully for (4)

Answer 11

upper lung field involvement
fibrocalcific changes
pleural capping
calcified Ghon complex

Question 12

≥5-mm induration is positive in (5)

Answer 12

• Close contact
• HIV
• Immunosuppressed on prednisone >15 milligrams per day for >1 month
• CXR healed tuberculosis
• Organ transplants

Question 13

≥10-mm induration is positive in

Answer 13

INjection drug users
High-prevalence groups (immigrants, long-term care facility residents, persons in local high-risk areas)
Conditions that increase the risk of progression to active disease (silicosis; diabetes; carcinoma of the head, neck, or lung)
CHildren <4 y of age