Mi - TB

Question 1

what % of the world are infected with TB

Answer 1

33%

Question 2

in whom is TB more common in UK

Answer 2

homeless
Big towns like London / Leicester

Question 3

how many new cases of TB are there every year

Answer 3

10 million

Question 4

what is the biggest risk factor of TB

Answer 4

poverty

Question 5

why can TB cause poverty

Answer 5

stigmatised - attached to HIV
reduced QoL and working life

Question 6

where is drug resistant TB most common

Answer 6

Russia
Asia

Question 7

what bacteria causes most TBs

Answer 7

mycobacteria tuberculosis

Question 8

name other bacteria that can cause TB

Answer 8

m.tuberculosis (1)
m.bovis
m.africanum
m.microti
m.canetti

Question 9

who/what gets m.bovis TB

Answer 9

cattle / badgers

Question 10

which mycobacteria do NOT cause TB

Answer 10

m.avium
m.chelonae
m.abscessus
m.chimaera

Question 11

what does TB look like under microscope

Answer 11

sputum smear positive bacteria
bascillus

Question 12

who gets m.abscesus

Answer 12

CF pts

Question 13

who gets m.avium

Answer 13

HIV pts

Question 14

who gets m.chimaera

Answer 14

vascular bypass device pts

Question 15

what does m.chelonae cause

Answer 15

ulcerating, crusting skin lesion

Question 16

how is TB spread

Answer 16

via droplet nuclei in the air (aerosol)

Question 17

what 4 factors does the probability that TB will get transmitted depend on

Answer 17

infectiousness of person with TB
environment in which exposure occured
length of exposure
virulence of tubercle bacilli

Question 18

what is the best way to stop transmission

Answer 18

isoaltion
treat infected person

Question 19

what lifetime % of TB infected people go on to become unwell with TB

Answer 19

10%

Question 20

what lifetime % of TB infected HIV pts go on to become unwell with TB

Answer 20

30-50%

Question 21

how do you prevent latent TB becoming active

Answer 21

diagnosis + chemoprophylaxis

Question 22

Sx of TB

Answer 22

fever, weight loss, night sweats, 2-3 weeks cough

Question 23

how is latent TB infection diagnosed

Answer 23

mantoux with PPD or gamma interferon release assays (IGRA)

Question 24

what is incubation period of TB

Answer 24

3-9 months but always UNDER 2 YEARS

Question 25

are most people unwell with TB unwell do to reactivation of latent TB or reinfection?

Answer 25

exogenous reinfection

Question 26

what 4 drugs are used in Mx of TB

Answer 26

RIPE rifampicin isoniazid pyrazinamide ethambutol

Question 27

what is the drug Tx regime inc timings for TB

Answer 27

RIPE for 2 months rifampicin and isoniazid for 4 months (total 6 months) daily therapy, orally

Question 28

what baseline checks are done when someone is on drug Tx for TB

Answer 28

baseline CXR, LFTs, FBC, U&Es, CRP

Question 29

when is the drug Tx regime extended in TB and to how long

Answer 29

TB meningitis 12 months Tx

Question 30

what % of TB must be eradicated in a country for that country to be TB free

Answer 30

80%

Question 31

what is the turn around time for a microscopy ZN stain for TB detection

Answer 31

30 mins

Question 32

what is the turn around time for a solid culture for TB detection

Answer 32

4-6 weeks

Question 33

which 3 countries have the highest rates of drug resistant TB

Answer 33

india china russia

Question 34

what factor influences the prognosis of someone with multidrug resistant TB and HIV

Answer 34

whether they get the correct drug regime or not

Question 35

how does TB become multi drug resistant

Answer 35

resistance is a natural phenomenon poor Tx encourages resistance selection pressures and advantages increase prevalence of the resistance

Question 36

how is drug resistant TB reduced

Answer 36

use multiple drugs to treat TB

Question 37

how can drug resistant TB be quickly diagnosed

Answer 37

molecular line probe assays using PCR

Question 38

how can whole genome sequencing be used in TB diagnosis

Answer 38

speciation - is the mycobacterium TB causing or not relatedness - transmission and tracking drug resistant or not

Question 39

give 4 steps in next generation sequencing for whole genome sequencing in TB

Answer 39

cultivation of pathogen DNA extraction library preparation sequencing

Question 40

how much more expensive is it to treat multi drug resistant vs drug sensitive TB

Answer 40

10x more

Question 41

what % of mutli drug resistance TB can be predicted by WGS

Answer 41

90%

Question 42

what is the gene for rifampicin resistance

Answer 42

RPOB

Question 43

what is the efficacy of BCG vaccine

Answer 43

70%