Pulmonary TB

Question 1

What is a Ghon lesion?

Answer 1

Calcified parenchymal focus (granuloma). Later stage of granuloma in TB disease progression.

Question 2

What is a Ranke Complex?

Answer 2

AKA Ghon Complex

It is a Ghon lesion (calcified granuloma) plus infected hilar lymph nodes

Question 3

Type of Hypersensitivity rxn of a positive PPD (purified protein derivative test)

Answer 3

Type IV

Question 4

When assessing a positive PPD test, a papule that is at or greater than 5mm in diameter should be considered a (+) TB infection for which populations?

Answer 4

HIV pts
Close contact with infected pts
IC pts

Question 5

When assessing a positive PPD test, a papule that is at or greater than 10mm in diameter should be considered a (+) TB infection for which populations?

Answer 5

People with clinical conditions that are not considered IC conditions

Cancers

Children younger than 4

Workers and inmates at prisons, workers in micro labs, homeless

People born in endemic areas

Question 6

When assessing a positive PPD test, a papule that is at or greater than 15mm in diameter should be considered a (+) TB infection for which populations?

Answer 6

Healthy people with no risk factors

Question 7

Gold standard for definitive TB diagnosis.

Answer 7

Sputum culture (acid fast)

Question 8

How does the INF-gamma assay test for TB?

Answer 8

Take a patient’s blood and expose it to TB.

1. measure the INF-gamma levels released by T cells
2. Higher levels indicate a strong T cell response meaning that the patient has been exposed to TB

Question 9

What is the first precaution taken with patients confirmed to be infected with TB?

Answer 9

Isolation

• N95 mask
• negative pressure room

Question 10

What is the combo medication regimen for active TB patients?

Answer 10

RIPE
Rifampin
Isoniazid
Pyrazinamide
Ethambutol
-Tx normally lasts 6 months

Question 11

How are HIV patients treated for TB infection?

Answer 11

Same as non-HIV individuals

Question 12

What is the treatment for latent TB

Answer 12

Isoniazid for 9 months
or
Rifampin for 4 months

Question 13

Biggest complication of miliary TB

Answer 13

Spread to multiple organ systems