Tuberculosis

Question 1

Should be added to the regimen to prevent isoniazid-related neuropathy. (Harrison’s 19th edition, pp 1116)

Answer 1

Pyridoxine 10-25mg/d

Question 2

High risk of vitamin B6 deficiency. (Harrison’s 19th edition, pp 1116)

Answer 2

Alcoholics
Malnourished persons
Pregnant
Lactating women

Question 3

Conditions associated with neuropathy. (Harrison’s 19th edition, pp 1116)

Answer 3

Chronic renal failure
Diabetes
HIV infection

Question 4

Persons that should be given pyridoxine to prevent isoniazid-related neuropathy. (Harrison’s 19th edition, pp 1116)

Answer 4

High risk of vitamin B6 deficiency

Conditions associated with neuropathy

Question 5

Candidates for treatment of latent mycobacterium tuberculosis infection if tuberculin reaction size is >/= 5mm. (Harrison’s 19th edition, pp 1120)

Answer 5

HIV infected persons
Recent contacts of a patient with TB
Organ transplant recipients
Persons with fibrotic lesions consistent with old TB on chest radiography
Persons who are immunosuppressed (use of glucocorticoids or TNF-a inhibitors)
Persons with high-risk medical conditions (silicosis and ESRD on dialysis)

Question 6

Candidates for treatment of latent mycobacterium tuberculosis infection if tuberculin reaction size is > /= 10mm. (Harrison’s 19th edition, pp 1120)

Answer 6

Recent immigrants (< or = 5 years) from high-prevalence countries
Injection drug users
Mycobacteriology laboratory personnel
Residents and employees of high-risk congregate settings (correctional facilities, nursing homes, homeless shelters, hospitals and other health care facilities)
Children < 5 years of age; children and adolescents exposed to adults in high risk categories

Question 7

Smears that are positive after __ months of treatment when the patient is known to be adherent are indicative of treatment failure and possible resistance. (Harrison’s 19th edition, pp 1117)

Answer 7

3 months

Question 8

Monitoring by AFB smear examination should be undertaken at. (Harrison’s 19th edition, pp 1120)

Answer 8

2, 5, and 6 months

Question 9

In Tuberculosis, Recommended treatment regimen for new smear- or culture-positive cases. (Harrison’s 19th edition, pp 1116)

Answer 9

2HRZE/4HR

Question 10

In Tuberculosis, Recommended treatment regimen for new culture-negative cases. (Harrison’s 19th edition, pp 1116)

Answer 10

2HRZE/4HR

Question 11

In Tuberculosis, Recommended treatment regimen for pregnant patients. (Harrison’s 19th edition, pp 1116)

Answer 11

2HRE/7HR

Question 12

In Tuberculosis, Recommended treatment regimen for relapse and treatment default. (Harrison’s 19th edition, pp 1116)

Answer 12

3HRZES/5HRE

Question 13

Recommend daily dosage of Isoniazid for initial treatment of tuberculosis in adults. (Harrison’s 19th edition, pp 1115)

Answer 13

5mg/kg, max 300mg

Question 14

Recommend daily dosage of Rifampicin for initial treatment of tuberculosis in adults. (Harrison’s 19th edition, pp 1115)

Answer 14

10mg/kg, max 600mg

Question 15

Recommend daily dosage of Ethambutol for initial treatment of tuberculosis in adults. (Harrison’s 19th edition, pp 1115)

Answer 15

15mg/kg

Question 16

Recommend daily dosage of Pyrazinamide for initial treatment of tuberculosis in adults. (Harrison’s 19th edition, pp 1115)

Answer 16

25mg/kg, max 2g

Question 17

Recommend Thrice-weekly dosage of Isoniazid for initial treatment of tuberculosis in adults. (Harrison’s 19th edition, pp 1115)

Answer 17

10mg/kg, max 900mg

Question 18

Recommend Thrice-weekly dosage of Rifampicin for initial treatment of tuberculosis in adults. (Harrison’s 19th edition, pp 1115)

Answer 18

10mg/kg, max 600mg

Question 19

Recommend Thrice-weekly dosage of Ethambutol for initial treatment of tuberculosis in adults. (Harrison’s 19th edition, pp 1115)

Answer 19

30mg/kg

Question 20

Recommend Thrice-weekly dosage of Pyrazinamide for initial treatment of tuberculosis in adults. (Harrison’s 19th edition, pp 1115)

Answer 20

35mg/kg, max 3g

Question 21

Other terms for Postprimary TB infection. (Harrison’s 19th edition, pp 1108)

Answer 21

Reactivation
Secondary TB
Adult-type TB

Question 22

May result from endogenous reactivation of distant LTBI or recent infection. (Harrison’s 19th edition, pp 1108)

Answer 22

Postprimary (adult-type) TB

Question 23

Usual location for Postprimary (Adult-type TB). (Harrison’s 19th edition, pp 1108)

Answer 23

Apical and posterior segments of the upper lobes

Superior segments of the lower lobes

Question 24

Produced by massive involvement of pulmonary segments or lobes with coalescence of lesions. (Harrison’s 19th edition, pp 1108)

Answer 24

Caseating pneumonia

Question 25

Liquefied necrotic contents in the TB. (Harrison’s 19th edition, pp 1108)

Answer 25

Cavity formation/cavitation

Question 26

Defined as untreated patients reportedly succumb to severe pulmonary TB within a few months after onset. (Harrison’s 19th edition, pp 1108)

Answer 26

Classic “galloping consumption” of the past

Question 27

Chronic progressively debilitating course of Postprimary (Adult-type) disease. (Harrison’s 19th edition, pp 1108)

Answer 27

“Consumption” | Phthisis

Question 28

Signs and symptoms of Postprimary (adult-type) Disease. (Harrison’s 19th edition, pp 1108)

Answer 28

``` Diurnal fever Night sweats Weight loss Anorexia General malaise Weakness Cough Hemoptysis Pleuritic Chest pain Dyspnea ```

Question 29

Most common hematologic findings in Postprimary (adult-type) Disease. (Harrison’s 19th edition, pp 1109)

Answer 29

Mild anemia Leukocytosis Thrombocytosis Slightly elevated ESR and/or CRP

Question 30

Cause of hemoptysis in TB. (Harrison’s 19th edition, pp 1108)

Answer 30

Erosion of blood vessel in the wall of a cavity Rupture of dilated vessel in a cavity (rasmussen’s aneurysm) Aspergilloma formation in an old cavity

Question 31

Most common site of extrapulmonary TB. (Harrison’s 19th edition, pp 1109)

Answer 31

Lymph nodes

Question 32

Most common presentation of extrapulmonary TB on both HIV-seronegative and HIV-infected patients. (Harrison’s 19th edition, pp 1109)

Answer 32

Lymph node TB (Tuberculous lymphadenitis)

Question 33

Painless swelling of the lymphnodes, most commonly at posterior cervical and supraclavicular sites. (Harrison’s 19th edition, pp 1109)

Answer 33

Scrofula

Question 34

Diagnosis of Lymph node TB (Tuberculous lymphadenitis) is established by. (Harrison’s 19th edition, pp 1109)

Answer 34

Fine-needle aspiration biopsy | Surgical excision biopsy

Question 35

Characteristic of granulomas in HIV infected patients. (Harrison’s 19th edition, pp 1109)

Answer 35

Less well organized Frequently absent entirely Bacterial loads are heavier