Tuberculosis

Question 1

Determination in pleural concentration serves as a useful screening test, TB may be excluded if value is low

Answer 1

Adenosine Deaminase (ADA)

Question 2

Most potent risk factor for TB among infected individuals

Answer 2

HIV co-infection

Question 3

Two host responses to M.tuberculosis to develop

Answer 3

1. macrophage-activating cellular mediated immunity response

2. tissue-damaging response

Question 4

Basis of reactivity of Tuberculin Skin Testing (TST)

Answer 4

Delayed-Type Hypersensitivity to M.tuberculosis

Question 5

Primary PTB commonly affects which lung zones?

Answer 5

Middle and Lower Lung Zones

Question 6

Postprimary or Secondary TB commonly affects which lung lobes?

Answer 6

Apical and Posterior segments of the Upper Lobes (high mean o2 tension)

Superior segments of the Lower Lobes

Question 7

Hemoptysis resulting from rupture of a dilated vessel in a cavity

Answer 7

Rasmussen’s aneurysm

Question 8

Ghon focus + with or without overlying pleural reaction + thickening + regional lymphadenopathy

Answer 8

Ghon complex

Question 9

MC presentation of extrapulmonary TB in both HIV and HIV-seronegative patients

Answer 9

Tuberculous Lymphadenitis

Question 10

MC site of scrofula

Answer 10

Posterior cervical and supraclavicular sites

Question 11

Definitive diagnosis for genitourinary TB

Answer 11

Culture of THREE morning urine specimens

Question 12

MC affected in skeletal TB

Answer 12

Weight-bearing joints
Spine 40%
Hips 13%
Knees 10%

Question 13

Most commonly affected in spinal TB

Answer 13

Adults:
Lower Thoracic
Upper Lumbar

Children:
Upper Thoracic

Question 14

Most commonly affected with TB of the hip joints

Answer 14

Head of the femur

Question 15

MC sites of GI TB

Answer 15

Terminal Ileum

Cecum

Question 16

Pathognomonic of Miliary TB

Answer 16

Choroidal Tubercles

Question 17

Exacerbations in systemic or respiratory ssx and lab or radio manifestations of TB with the administration of ARTs in HIV-infected TB patients

Answer 17

Immune reconstitution inflammatory syndrome (IRIS)

Question 18

MC adverse drug reaction of TB drugs toxicity

Answer 18

Hepatitis

Question 19

Adverse drug reaction to individual TB drugs

Answer 19

Pyrazinamide: hyperuricemia and arthralgia (Tx: acetylsalicylic acid)

Rifampin: Autoimmune thrombocytopenia (Tx: stop)

Ethambutol: Optic Neuritis (Tx: stop)

Question 20

Initiation of ART to HIV-positive on anti-TB therapy

Answer 20

Regardless of CD4 count: Within the first 8 weeks of anti-TB

CD4 <50/uL: Within the first 2 weeks of anti-TB

Question 21

Adverse drug reaction of Streptomycin to the fetus of pregnant women with TB

Answer 21

CN 8 damage

same with adults

Question 22

Sputum collection for Direct Sputum Smear Microscopy (DSSM)

Answer 22

2 specimens
spot-spot one hour apart or
spot-early morning collection
(at least 1 sputum smear positive to consider Bacteriologically-confirmed)