Tuberculosis Control Program

Question 1

What is the Tuberculosis Control Program instruction?

Answer 1

BUMEDINST 6224.8C

Question 2

NAVMED 6224/7

Answer 2

Initial Tuberculosis Exposure Risk Assessment

Question 3

NAVMED 6224/8

Answer 3

Tuberculosis Exposure Risk Assessment

Question 4

NAVMED 6224/9

Answer 4

Monthly Evaluation for Patients Receiving Treatment for Latent Tuberculosis Infection (LTBI)

Question 5

DD Form 2766

Answer 5

Adult Preventive and Chronic Care Flowsheet

Question 6

NAVMED 6230/4

Answer 6

Adult Immunizations Record

Question 7

NAVMED 6230/5

Answer 7

Child Immunizations Record

Question 8

What type of test are available for identifying individuals asymptomatically infected with the Mycobacterium tuberculosis complex bacteria that cause TB

Answer 8

Skin and blood tests

Question 9

Who all are required to be tested for LTBI unless there is documentation of previous TB infection

Answer 9

All Navy/Marine Corps accessions, and all Military Sealift Command civilian mariners (CIVMARs).

Question 10

What form is used to screen all Active and Reserve Component military personnel annually to determine their TB exposure history and risk of acquiring TB, and can be done during PHA?

Answer 10

NAVMED 6224/8

Question 11

Individuals with a history of active TB, a positive Tuberculin Skin Test (TST) or Interferon Gamma Release Assa (IGRA), or treatment for LTBI must provide what documentation

Answer 11

Medical documentation of clinical evaluations, hospitalizations, diagnoses, and treatments.

Question 12

The purpose of LTBI testing is what?

Answer 12

To identify those who require prophylactic therapy.

Question 13

Can both TST and IGRA be performed?

Answer 13

No. Either or. Not both

Question 14

What is the approved TST material for the routine Mantoux test (PPD test)?

Answer 14

The Tween-80-stabilized intermediate strength PPD (5 tuberculin unit equivalent)

Question 15

The TST reaction must be read within how many hours after PPD administration?

Answer 15

48-72 hours

Question 16

If a person returns more than 72 hours after TST placement, record the result as “___________” and apply a TST where?

Answer 16

“Not Read”, apply on opposite forearm

Question 17

When recording TST result, if there is no induration, record result as “__________”?

Answer 17

“zero mm”

Question 18

What 3 FDA approved IGRAs are available for LTBI testing?

Answer 18

QuantiFERON-TB Gold (QFT), QuantiFERON-TB Gold Plus (QFT-Plus), and T-SPOT.TB (T-SPOT)

Question 19

True or False. TST results in persons vaccinated with Bacillus Calmette Guerin (BCG) immunization will be interpreted and treated using the same criteria for those not BCG vaccinated?

Answer 19

True

Question 20

If a person gives an undocumented history of a positive IGRA or TST without documentation of an adequate course of treatment for LTBI or active TB, what should you do?

Answer 20

Perform an IGRA or TST

Question 21

Are contractors and their employees required to undergo TB screening and targeted testing?

Answer 21

Yes, whenever said employees are working in an environment where DON employee are required to undergo testing.

Question 22

Evaluate all individuals with a TST induration of _______ to determine if their test is positive?

Answer 22

> 5 mm

Question 23

An increase in reaction size of ________, within a 2-year period, is considered a positive test?

Answer 23

10mm or more

Question 24

*THERE ARE 3 RISK GROUPS IN CRITERIA FOR DETERMINING A POSITIVE TST REACTION

Answer 24

(HIGH, MEDIUM, AND LOW RISK*

Question 25

This risk group has a reaction of >5 mm of induration and is positive in recent close contacts of active TB disease patients, persons with fibrotic or other changes on chest radiograph, and patients suspected of having active TB disease?

Answer 25

High Risk

Question 26

This risk group has a reaction of >10 mm of induration and is considered positive in recent immigrants (within last 5 years) from high TB areas, healthcare workers and others at risk of occupational exposure to TB, and persons with clinical conditions that place them at increased risk for TB disease progression?

Answer 26

Medium Risk

Question 27

In the Low Risk group, reaction of >15 mm of induration is considered positive in persons with ____ risk factors for TB?

Answer 27

Zero

Question 28

A person with suspected active TB should be masked and isolated immediately and evaluated at an MTF. The evaluation of positive tests must include what 3 things?

Answer 28

Physical Exam and Medical History, Chest Radiograph, and Sputum Examination

Question 29

Which lab testing are indicated for patients whose initial evaluation suggests an elevated risk for a liver disorder, such as persons who use alcohol regularly?

Answer 29

• Serum aspartate aminotransferase (AST), aka serum glutamic oxaloacetic transaminase (SGOT)
• alanine aminotransferase (ALT), aka serum glutamate pyruvate transaminase (SGPT)
• bilirubin

Question 30

Consider withholding medication if a patient’s transaminase levels exceed _____ times the upper limit of normal if associated with symptoms, or _____ times the upper limit of normal if the patient is asymptomatic?

Answer 30

3 time if with symptoms and 5 times if asymptomatic

Question 31

Members leaving active service are eligible or not eligible for continued LTBI treatment and can or cannot schedule follow up care at the Department of Veterans Affairs facilities by calling the local VA prior to separation or discharge?

Answer 31

Are eligible and can schedule followup

Question 32

Upon discovery of a suspected or confirmed case of active (infectious) TB in a beneficiary diagnosed at a Navy MTF, the responsible medical department rep must notify who?

Answer 32

The cognizant NAVENPVNTMEDU

Question 33

Who is responsible for ensuring the contact investigation is initiated rapidly?

Answer 33

The medical department representative for individual diagnosed with active TB disease

Question 34

Personnel who are enrolled in a contact investigation but are separating from the Service before the 8-10 week repeat test for TB infection, must be identified to who for follow-up testing?

Answer 34

The local public health department

Question 35

When protecting non-infected persons in spaces occupied by patients with infectious TB, what is designed to prevent respiratory secretions from entering the air?

Answer 35

Surgical masks

Question 36

When protecting non-infected persons in spaces occupied by patients with infectious TB, what is designed to filter air before it is inhaled by the person wea ring the respirator?

Answer 36

Particulate respirators (i.e., N95)

Question 37

True or False. Patients with suspected or know active TB should wear surgical masks when indicated and should not wear particulate respirator, with or without an exhalation valve.

Answer 37

True

Question 38

True or False. Medical department personnel must wear particulate respirators (N95 minimum) when working in rooms or spaces containing a person with known or suspected active TB.

Answer 38

True

Question 39

Medical Event Reports must be submitted within how many hours for all known or suspected cases of active TB?

Answer 39

24 hours.