BUMEDINST 6224.8B TB Control Program

Question 1

What is the TB Control Program instruction number?

Answer 1

BUMEDINST 6224.8B

Question 2

Who is responsible for providing technical support as needed to all Navy and Marine Corps units in their AOR?

Answer 2

OICs of NAVENPVNTMEDUs

Question 3

What is NAVMED 6224/7?

Answer 3

Initial TB Exposure Risk Assessment

Question 4

What is NAVMED 6224/8?

Answer 4

TB exposure Risk Assessment

Question 5

What is NAVMED 6224/9?

Answer 5

Monthly evaluation for PTs receiving treatment for Latent TB Infection.

Question 6

What is NAVMED 6230/4?

Answer 6

Adult Imms Record

Question 7

What is NAVMED 6230/5?

Answer 7

Child Imms Record

Question 8

What is the complex bacteria that causes TB?

Answer 8

Mycobacterium Tuberculosis

Question 9

What is LTBI?

Answer 9

Latent Tuberculosis Infection

Question 10

True or False:

All Navy and Marine Corps accessions must be tested for LTBI unless there is documented or previous TB infections?

Answer 10

True

Question 11

True or False:
All individuals beginning employment as Civilian Mariners for MSC must be tested for LTBI unless there is documented or previous TB infections?

Answer 11

True

Question 12

All personnel must be screened for LTBI during their operations suitability screening after receipt of PCS orders to a commissioned vessel. Screening or testing documentation within how long prior to reporting aboard is acceptable?

Answer 12

6 months

Question 13

When will all active duty and reserve personnel be screened for LTBI other then during accession?

Answer 13

during their PHA

Question 14

During a member’s PHA, what form should be used to determine their TB exposure history and risk of acquiring TB?

Answer 14

NAVMED 6224/8

TB risk assessment

Question 15

what are four examples of additional TB screening other than during a PHA or accession? (4)

Answer 15

1. As directed by combatant commanders.
2. As part of a contact or outbreak investigation.
3. if clinically indicated
4. as recommend by cognizant NAVENPVNTMEDUs

Question 16

perform TB screening on all personnel prior to or within how long prior to arrival on a commissioned vessel?

Answer 16

6 months

Question 17

Is TB testing required for personnel separating from naval service 6 months before separation or retirement?

Answer 17

no

Question 18

What does PPD stand for?

Answer 18

Tuberculin, Purified Protein Derivative

Question 19

What is the approved tuberculin skin test material?

Answer 19

Mantoux test:

Tween-80-stablized intermediate strength

Question 20

What is the preferred product of tuberose?

Answer 20

from Sanofi Pasteur

Question 21

What is an alternative tuberose product?

Answer 21

Aplisol from Parkedale Pharmaceuticals

Question 22

Record PPD test on one of what two forms?

Answer 22

NAVMED 6230/4 or NAVMED 6230/5

Question 23

The TST reaction must be read between what time after PPD administration?

Answer 23

48 to 72 hours

Question 24

If a person returns more that 72 hours after TST placement what do you do?

Answer 24

record “not Read” in the record, and apply a TST on the opposite forearm.

Question 25

what must you record as the results for a TST?

Answer 25

mm of induration

Question 26

If there is no induction after the administration of a TST what do you record in the record?

Answer 26

0mm or zero mm

Question 27

What is available as a as a diagnostic aid for M. Tuberculosis infection?

Answer 27

BAMT Blood Assay for M. Tuberculosis or a TST

Question 28

What type of BAMT does the Navy use?

Answer 28

QuantiFERON-TB Gold (QFT-G)

Question 29

True or False: | QFT-G is designed for use in place of, not in addition to, a TST

Answer 29

True

Question 30

Based on historical TST results associated with routine screening, the rate of newly-identified LTBI converters is normally no more that __ to __ percent of personnel tested per year in most Navy and MC settings.

Answer 30

1-2 percent

Question 31

What is a BCG immunization?

Answer 31

Bacillus Calmette Guérin

Question 32

TSTs can be administered to persons who have previously received BCG immunizations however, a positive TST reaction should be regarded how?

Answer 32

as indicative of a TB infection and they must be evaluated for active TB prior to receiving treatment for LTBI

Question 33

A TST may be placed on the same day as parenteral live-attenuated virus vaccines or given at least how long later?

Answer 33

4 weeks

Question 34

Are TSTs safe during pregnancy?

Answer 34

yes | they are both safe and reliable throughout pregnancy and should be administered as appropriate

Question 35

Can you use the two-step procedure for recruit or officer accession screening or other active duty screening programs?

Answer 35

no

Question 36

Can members with a positive TST deploy?

Answer 36

not until evaluations are completed and all results have been reported

Question 37

evaluate all individuals with a TST induration greater than or equal to __mm to determine if their test is positive.

Answer 37

5 mm

Question 38

What are three factors that would place a member into the "high risk" for acquiring TB?

Answer 38

1. Recent close contact of active TB disease PTs 2. Persons with fibrotic or other changes on chest X-rays with prior TB 3. PT suspected of having active TB

Question 39

What are three factors that would place a member into the "medium risk" for acquiring TB?

Answer 39

1. Recent immigration (i.e. within the last 5 years) from hight TB prevalence countries. 2. Mycobacteriology laboratory personnel 3. persons with clinical conditions that place them at increased risk

Question 40

A high risk PT with a __mm TST reaction is considered to be positive.

Answer 40

5mm

Question 41

A medium risk PT with a __mm TST reaction is considered to be positive

Answer 41

10mm

Question 42

A low risk PT with a __mm TST reaction is considered to be positive.

Answer 42

15mm

Question 43

Chest X-rays should be examined for what changes consistent with old TB?

Answer 43

fibrotic

Question 44

A person with suspected active disease should be masked and ____ed immediately and then referred to an appropriate provider at a MTF.

Answer 44

isolated

Question 45

If active TB is ruled out and the individual meets the criterion for LTBI, ___ treatment shall be initiated unless medically contraindicated.

Answer 45

Isoniazid (INH)

Question 46

what is the preferred INH treatment regimen?

Answer 46

5mg/kg (300mg max) daily for 9 months to accomplish 270 daily doses within 12 months

Question 47

What is the alternate INH treatment regimen?

Answer 47

INH 15mg/kg (900mg max) Twice weekly for 9 months only in combination with directly observed therapy

Question 48

Are baseline laboratory testing routinely indicated for PTs at the start of LTBI TX?

Answer 48

no

Question 49

Routine laboratory monitoring is necessary for what individuals?

Answer 49

individuals whose baseline liver function tests are abnormal

Question 50

how frequently must individuals receiving therapy for LTBI follow up ?

Answer 50

monthly until tx is completed

Question 51

what form is used to document monthly follow ups?

Answer 51

NAVMED 6224/9 | Monthly Evaluation of PTs receiving Therapy for LTBI

Question 52

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

Answer 52

perform a BAMT or TST

Question 53

Where do you document patient education and counseling?

Answer 53

SF 600

Question 54

Upon successful completion of appropriate LTBi tx regimen , additional LTBI testing or chest x-rays need to be done?

Answer 54

no

Question 55

Do not restart the 9 month daily INH regimen if at least how many doses of INH can be administered within a 12 month period.

Answer 55

270

Question 56

What happens if INH treatment has been interrupted for more that two months?

Answer 56

PT must be examined to exclude active TB disease