Tuberculosis - Pataskia

Question 1

TB progression in relation to testing: active TB disease

Answer 1

TST: usually +
IGRA: usually +
culture: +
sputum smear: + or -
infectious: yes
sx: mild-severe
preferred treatment: multidrug therapy

Question 2

TB progression in relation to testing: subclinical TB disease

Answer 2

TST: +
IGRA: +
culture: intermittently +
sputum smear: usually -
infectious: sporadically
sx: mild or none
preferred treatment: multidrug therapy

Question 3

TB progression in relation to testing: latent TB infection

Answer 3

TST: +
IGRA: +
culture: -
sputum smear: -
infectious: no
sx: none
preferred treatment: preventive therapy

Question 4

TB progression in relation to testing: infection eliminated with acquired immune response

Answer 4

TST: +
IGRA: +
culture: -
sputum smear: -
infectious: no
sx: none
preferred treatment: none

Question 5

TB progression in relation to testing: infection eliminated with innate immune response

Answer 5

TST: -
IGRA: -
culture: -
sputum smear: -
infectious: no
sx: none
preferred treatment: none

Question 6

Which LTBI medication would you typically want to avoid or be cautious with in pts living with HIV?

Answer 6

rifampin

Question 7

What is drug susceptible TB?

Answer 7

TB strains that are sensitive to the standard 1st line agents

Question 8

What is monoresistant TB?

Answer 8

TB strains that are sensitive to just one anti-TB drug

Question 9

What is polyresistant TB?

Answer 9

TB strains that are resistant to more than one anti-TB drug but not INH (isoniazid) and RIF (rifampin)

Question 10

What is multidrug resistant TB?

Answer 10

TB strains that are resistant to RIF and INH

Question 11

What is extensively drug-resistant TB?

Answer 11

TB strains that are resistant to RIF and INH + at least one injectable agent (amikacin, kanamycin, or capreomyci) + any of the FQs

Question 12

What is the treatment of drug susceptible TB? - standard 6mo treatment

Answer 12

intensive phase: rifampin 600mg + isoniazid 300mg + ethambutol 800-1600mg + pyrazinamide 1000-2000mg once/day x 8 weeks
continuation phase: rifampin 600mg + isoniazide 300mg once/day x 18 weeks

Question 13

What is the treatment of drug susceptible TB? - 4mo treatment

Answer 13

intensive phase: rifapentine 1200mg + isoniazid 300mg + moxifloxacin 400mg + pyrazinamide 1000-2000mg once/day x 8 weeks
continuation phase: rifapentine 1200mg + isoniazid 300mg + moxifloxacin 400mg once/day x9 weeks