TB Manual

Question 1

Primary defenses against TB

Answer 1

Macrophages and T-lymphocytes

Question 2

MTB Survival Strategies

Answer 2

1. Prevention of acidification of phagosomes
2. Neutralization of the effects of reactive oxygen intermediates by mycobacterial cell wall components
3. Inhibition of plasma membrane repair
4. Probable inhibition of phagosome-lysosomal fusion through secretion of SapM, PknG and glycosylated phosphotadyl-inositol

Question 3

Incubation Period

Answer 3

3 to 12 weeks

Question 4

Lesion located peripherally in any part of the lungs, close to the pleura

Answer 4

Ghon Focus

Question 5

Soft semi-solid core surrounded by epithelioid macrophages, Langerhans giant T-cells and lymphocytes

Answer 5

Granuloma

Question 6

Dissemination of bacilli from the primary granuloma in the lungs to the hilar nodes

Answer 6

Granulomatous lymphadenitis

Question 7

Combination of granulomatous lymphadenitis + ghon focus

Answer 7

Ghon Complex

Question 8

Compression of the bronchi to cause collapse of the distal lung due to enlarging hilar and mediastinal nodes

Answer 8

Middle Lobe Syndrome

Question 9

Progressive, widely disseminated hematogenous TB (numerous small, yellow-white nodules, less than 2mm

Answer 9

Miliary TB

Question 10

Close contact with contagious adult/adolescent without any signs and symptoms of TB, (-) TST, no radiologic or laboratory findings of TB

Answer 10

TB Exposure

Question 11

(+) TST reaction only

Answer 11

TB Infection

Question 12

(+) smear microscopy, culture or rapid diagnostic test

Answer 12

Bacteriologically-confirmed TB Disease

Question 13

Does not fulfill the criteria for bacteriologic confirmation but has signs and symptoms of TB

Answer 13

Clinically-diagnosed TB Disease

Question 14

3 elements of PTB Primary Disease

Answer 14

Ghon Focus
Lymphadenitis
Lymphangitis

Question 15

Most common extrapulmonary sites of Miliary TB

Answer 15

Lymphatic
Bones/Joints
Liver

Question 16

Enlargement of peribronchial lymph nodes with subsequent compression of intrabronchial, the nodal extension into the bronchus

Answer 16

Endobronchial TB

Question 17

Most common form of extrapulmonary TB

Answer 17

Tuberculous lymphadenitis

Question 18

Most common cause of chronic lymphadenitis in children

Answer 18

Tuberculous lymphadenitis

Question 19

TB lymphadenitis in the cervical region

Answer 19

Scrofula

Question 20

Most common location of TB lymphadenitis in children

Answer 20

Anterior cervical region

Question 21

Direct extension of the TB into the skin

Answer 21

Scrofuloderma

Question 22

Most severe form of extrapulmonary TB

Answer 22

TB Meningitis

Question 23

Most common organ involved in extrapulmonary TB

Answer 23

Meninges

Question 24

Enlarged granulomatous foci within the brain parenchyma

Answer 24

Tuberculoma

Question 25

Area affected the most in tuberculous spinal meningitis

Answer 25

Dorsal Cord

Question 26

Most common site affected by TB of bones/joints

Answer 26

Spine

Question 27

Rupture of caseous abdominal lymph node

Answer 27

TB peritonitis

Question 28

Constant indicator of peritoneal disease

Answer 28

Ascites

Question 29

Routes of perinatal or postnatal TB

Answer 29

Hematogenous spread Ingestion of infected amniotic fluid Postpartum inhalation

Question 30

TST Positive cut off size for HIV

Answer 30

>5mm

Question 31

TST Positive cut off size for person who had close contact with TB

Answer 31

>5mm

Question 32

TST Positive cut off size for organ transplant recipients

Answer 32

>5mm

Question 33

TST Positive cut off size for immunosuppressed patients

Answer 33

>5mm

Question 34

TST Positive cut off size for persons living in areas where TB is highly prevalent

Answer 34

>10mm

Question 35

TST Positive cut off size for population with NO risk factor

Answer 35

>15mm

Question 36

Inability to react to TST because of a weakened immune system

Answer 36

Anergy

Question 37

How many increase in reaction size of induration within a period of 2 years for persons with previous negative TST reaction to be classified as convertion to positive

Answer 37

>10mm

Question 38

Temperature for storage to tuberculin solution

Answer 38

2 to 8C

Question 39

True or False: A history of BCG vaccine is not a contraindication for TST

Answer 39

True

Question 40

True or False: About 80-90% of children who received BCG in their infancy have non-reactive TST at 5 years of age

Answer 40

True

Question 41

Most potent sterilizing drug

Answer 41

Rifampicin

Question 42

Prevents emergence of resistant bacilli

Answer 42

Ethambutol

Question 43

Bactericidal against rapidly multiplying TB in an environment with high oxygen tension and neutral pH

Answer 43

Streptomycin

Question 44

Active in the acidic intracellular environment and inflammation where it exerts its sterilizing effects

Answer 44

Pyrazinamide

Question 45

Best bactericidal activity versus rapidly multiplying MTB

Answer 45

Isoniazid

Question 46

Prevents development of infection among contacts exposed to active disease

Answer 46

Primary prophylaxis

Question 47

Prevents progression of LTBI to disease

Answer 47

Secondary prophylaxis

Question 48

Prophylactic dose of Isoniazid

Answer 48

6-month regimen of Isoniazid given at 10mg/kg OD