Tuberculosis

Question 1

Define TB and what is the causative agent

Answer 1

Communicable Infectious disease caused by Mycobacterium tuberculosis (acid fast bacilli)
Can be silent and latent
Or progressive

Question 2

How is TB transmitted

Answer 2

Mixrosize droplet nuclei dispersed via coughing and sneezing
Laryngeal TB infection via talking too

Question 3

TB diagnosis

Answer 3

Sputum smear microscopy (acid fast bacilli)
Sputum culture and sensitivity
Molecular assay e.g GeneXpert to diagyTB and resistance to Rifampicin
Chest X-ray

Question 4

When do you perform a culture and drug susceptibility test

Answer 4

HIV + with 2 -very sputum smear results
New patients smear +ve at month 3 of treatment
All retreatment patients
All children
Symptomatic and high MDR risk
TB after Isoniazide Preventative Therapy

Question 5

How to diagnose TB in kids

Answer 5

Tubercular skin test- Purified Protein Derivative
Chest X-ray
Microscopy and culture

Question 6

How to collect sputum from a child

Answer 6

1. Induce and collect from nasopharynx if young. Give salbutamol then 3% hypertonic saline via nebulization. Plus chest percussion and suction trap

Question 7

Risk factors for TB

Answer 7

Previous exposure
History of TB
Immunocompromised
Race
Age, gender, occupation (mines)
HIV positive
Diabetes
Smoking, alcoholism, malnutrition
Prolonged treatment with steroids

Question 8

Pediatric risk factors

Answer 8

Below 3 years
History of recent contact with TB
Immunocompromised

Question 9

Clinical presentation of TB

Answer 9

Loss of appetite
Weight loss
Malaise
Fever for 2 weeks or more
Night sweats
Persistent productive cough
Shortness of breath
Chest pains
Hemoptysis
Crepitation (crackling sound in lungs)

Question 10

Pediatric symptoms

Answer 10

Weight loss
Wheezing
coughing
night sweats
fever
enlarged lymph nodes
fatigue

Question 11

What are the main drugs

Answer 11

Isoniazide 5mg/kg
Rifampicin 10mg/kg
Pyrazinamide 25mg/kg
Ethambutol 15mg/kg
Streptomycin 15mg/kg if relapse

Question 12

What are the intensive and continuing therapies for Retreatment of TB

Answer 12

Intensive- 2HRZES/1HRZE
Continuation- 5HRE

Question 13

Intensive and continuation therapy for new infections

Answer 13

Intensive- 2HRZE
Continuation- 4HRE

Question 14

How would you prophylax TB

Answer 14

Children- Isoniazide
HIV positive patient- Cotrimoxazole