Tuberculosis

Question 1

the total lifetime risk of reactivation of TB in latent patients is __%

Answer 1

10%

Question 2

new TB infection or active disease in a previously naïve host

Answer 2

primary disease

Question 3

the name given to the formation of a tubercle and involvement of regional lymph nodes

Answer 3

Ghon Complex

Question 4

the risk of TB reactivation in the first 3 years after infection is ___% and ___% thereafter

Answer 4

5% and 5%

Question 5

after primary infection __% develop latent infection

Answer 5

90%

Question 6

progressive primary TB can affect other organ systems and may present as

Answer 6

cerivcal lymphadenopathy, meningitis, pericarditis

Question 7

clinical presentation of primary TB

Answer 7

prolonged fever, can be asymptomatic

Question 8

clinical presentation of reactivation TB

Answer 8

chronic prolonged history of cough, constitutional symptoms including fever, malaise, anorexia, weight loss, night sweats. sometimes chest pain or dyspnoea

Question 9

what rheumatological drug may reactivate latent TB?

Answer 9

TNF-alpha inhibitors

Question 10

what other infection may reactivate TB?

Answer 10

HIV

Question 11

what other systemic comorbidity increases the risk of reactivation of TB?

Answer 11

diabetes mellitus

Question 12

CXR shows hilar adenopathy and pleural effusion, likely phase of TB is __

Answer 12

primary TB

Question 13

CXR shows infiltrates of apical upper lobes and cavitations, likely phase of TB infection is __

Answer 13

reactivation TB

Question 14

Miliary or disseminated TB is most likely associated with

Answer 14

HIV and immunosuppression

Question 15

miliary TB can involve ___

Answer 15

bone (Pott’s disease in spine), choroid, meninges, liver, spleen, lung

Question 16

diagnosis of TB is confirmed via

Answer 16

typical CXR findings

acid-fast bacilli stain (Ziehl-Neelsen)

Question 17

the type of necrosis in TB infection is

Answer 17

caseating

Question 18

What physical exam tests must be done before initiating TB treatment?

Answer 18

Ishihara colour chart

Visual Acuity

Question 19

What infections must be screened for before starting therapy?

Answer 19

HIV

Hepatitis B and C serolgoy

Question 20

What laboratory blood tests should be ordered befroe initiating therapy?

Answer 20

EUC
Liver biochemistry
FBC

Question 21

what intervention can be used if worried about non-adherence to TB meds

Answer 21

directly observed therpay

Question 22

the intensive phase of TB therapy consists of

Answer 22

2 months isoniazid, rifampicin, ethambutol and pyrazinamide

Question 23

the continuation phase of TB therapy consists of

Answer 23

4 months rifampicin and isoniazid

Question 24

isoniazid may adversely cause

Answer 24

peripheral neuropathy

Question 25

those at risk of complications from isoniazid include

Answer 25

pregnant women, chronic renal disease, HIV, diabetes, hazardous alcohol use, malnutrition, old age

Question 26

ethambutol may adversely cause

Answer 26

optic neuritis (decreased coloru vision and visual acutiy)

Question 27

treatment of peripheral neuropathy secondary to isoniazid is

Answer 27

pyridoxine

Question 28

rifampicin may adversely cause

Answer 28

orange secretions | inactivation of the flu

Question 29

all TB drugs cause toxicity to

Answer 29

the liver

Question 30

Screening for latent TB can be performed suing

Answer 30

Tuberculin skin test | Interferon Gamma assay

Question 31

Positive tuberculin skin testing can indicate

Answer 31

immunity previous exposure BCG vaccine

Question 32

Positive IGRA indicates

Answer 32

previous exposure to TB

Question 33

A tuberculin skin test is performed in an immunocompetent patient, after 48-72hrs the induration is >10mm, this means

Answer 33

likely prior infection with TB

Question 34

A tuberculin skin test is performed in an immunodeficient patient, after 48-72hrs the induration is >5mm, this means

Answer 34

likely prior infection with TB