Bumedinst 6224.8 Tb Control Program

Front 1

Which BUMED instruction provides guidelines for a TB control program of screening, preventive therapy, case identification and treatment, and contact investigation to control TB among members of the Navy, Marine Corps, and in other medical beneficiaries?

Back 1

BUMEDINST 6224.8 TB control Program

Front 2

How many cases of TB occur annually in the US?

Back 2

20,000

Front 3

How can morbidity and mortality from TB be reduced?

Back 3

Early identification
Treatment of persons with TB

Front 4

What is the most sensitive and specific test available for identifying those who are infected with Mycobacterium TB?

Back 4

The TB skin test with Purified Protien Derivative (PPD)

Front 5

What bacterium causes TB?

Back 5

Mycobacterium TB

Front 6

What preventive therapy is the most effective measure to prevent the development of TB in newly infected persons?

Back 6

INH ( Isoniazid )

Front 7

True or False.. Preventive treatment totally eliminates the risk of TB?

Back 7

False. Preventive treatment reduces risk of TB, does not totally eliminate it.

( chances decrease 95% with treatment of INH for 9 months )

Front 8

What term describes the person that has no symptoms, signs, or radiographic evidence of active disease, but does have evidence of infection, as indicated by the presence of a positive TB skin test?

Back 8

Active disease

Front 9

What term describes the person that has no symptoms, signs, or radiographic evidence of active disease, but does have evidence of infection, as indicated by the presence of a positive TB skin test?

Back 9

TB infection

Front 10

True or false…For the purposes of the TB control program, all individuals who have positive TB skin tests are considered to have TB infection?

Back 10

True

Front 11

What method described a TB skin test using a syringe and needle to inject purified protien derivative (PPD) of tuberculin?

Back 11

Mantoux Method

Front 12

What term descibes an area around the site of tuberculin injection that is raised and firm to the touch?

Back 12

Induration

Front 13

What term describes a person with an area of induration to a 5 TU tuberculin skin test when read 48 to 72 hours after administration?

Back 13

TB reactor

Front 14

What term describes a person with an area od induration of less than 5mm to a 5 TU tuberculin skin test?

Back 14

TB non reactor

Front 15

What vaccines are made from live atteenuated mycobacteria strains are commonly used in some contries in and attempt to prevent vaccines from becomming infected with TB?

Back 15

BCG ( bacillus Calmette-Guerin ) Vaccines

Front 16

What city and state is NAVENPVNTMEDU TWO in?

Back 16

Norfolk, Virginia

Front 17

What city and state is NAVENPVNTMEDU FIVE in?

Back 17

San Diego, CA

Front 18

What city and state is NAVENPVNTMED SIX in?

Back 18

Pearl Harbor, HI

Front 19

City and state NAVENPVNTMEDU SEVEN?

Back 19

Naples, Italy

Front 20

What is the only approved TB skin test material for the Mantoux test?

Back 20

Pre-mixed Twwn-80 stabilized intermediate strength PPD ( 5 TU equivalent )

Front 21

Why are muliple puncture tuberculin tests ( Tine or Monovac tests) not used except on the specific reccomendation of the area NAVENPVNTMEDU?

Back 21

They produce significant numbers of both false positive and false negative tests results

Front 22

What type of syringe and needle is used for administration of a Mantoux test?

Back 22

disposable 1 ml tuberculin syringe graduated in 0.1 ml intervals and fitted with a 25-gauge 5/8 inch needle

Front 23

An infection person has a ___% lifetime chance of developing TB

Back 23

5%

Front 24

All personnel entering periods of duty less than ___ must have a result of skin test in record

Back 24

30

Front 25

Use disposable __ syringe fitted with a ___ga needle

Back 25

1 ml, 25 Gauge

Front 26

Why are muliple puncture tuberculin tests ( Tine or Monovac tests) not used except on the specific reccomendation of the area NAVENPVNTMEDU?

Back 26

They produce significant numbers of both false positive and false negative tests results

Front 27

What type of syringe and needle is used for administration of a Mantoux test?

Back 27

disposable 1 ml tuberculin syringe graduated in 0.1 ml intervals and fitted with a 25-gauge 5/8 inch needle

Front 28

An infection person has a ___% lifetime chance of developing TB

Back 28

5%

Front 29

All personnel entering periods of duty less than ___ must have a result of skin test in record

Back 29

30

Front 30

Use disposable __ syringe fitted with a ___ga needle

Back 30

1 ml, 25 Gauge

Front 31

Why are muliple puncture tuberculin tests ( Tine or Monovac tests) not used except on the specific reccomendation of the area NAVENPVNTMEDU?

Back 31

They produce significant numbers of both false positive and false negative tests results

Front 32

What type of syringe and needle is used for administration of a Mantoux test?

Back 32

disposable 1 ml tuberculin syringe graduated in 0.1 ml intervals and fitted with a 25-gauge 5/8 inch needle

Front 33

An infection person has a ___% lifetime chance of developing TB

Back 33

5%

Front 34

All personnel entering periods of duty less than ___ must have a result of skin test in record

Back 34

30

Front 35

Use disposable __ syringe fitted with a ___ga needle

Back 35

1 ml, 25 Gauge

Front 36

5TU= __ml

Back 36

.1 ML

Front 37

In inderation measurement falls between 2m divisions of scale, use ____ region

Back 37

lower

Front 38

If reactors in one group of people are less than ___ %, look for active case

Back 38

2.5%

Front 39

A reactor of equal to or greater than __ mm gets INH therapy reguardless of age

Back 39

10

Front 40

INH dose=__mg every day for __months

Back 40

300
6

Front 41

TB non reactor is a person with greater than __mm of induration to a 5 TU TB skin test

Back 41

5 mm

Front 42

If the oerson returns after 3 days but less than 10 and the induration is 0-14mm, make an entry of _______.

Back 42

Not read
Continue with ppd in opposite arm

Front 43

If the person returns from 3-10 days and the induration is __mm or more, treat the person as a reactor

Back 43

15

Front 44

In cases where TB is resistant to INH or patient is allergic, use ___ at a __ mg does

Back 44

Rifampin
600 mg does

Front 45

Active disease is most common due to disease being transmitted how?

Back 45

airborne

Front 46

non reactor?

Back 46

5mm or less

Front 47

annual screening

Back 47

ship board personnel, deployable units marine and navy, all health care workers

Front 48

Triennial screening

Back 48

reserves, pcs orders

Front 49

At what duration is considered positive if member returns more than 72 hours but less than 10 days?

Back 49

14 mm

Front 50

What aspect of the forearm is the interadermal injection made?

Back 50

Volar

Front 51

How many hours after administration of a TB skin test must it be examined?

Back 51

48 to 72 hours

Front 52

Who must read the TB skin test?

Back 52

mdr

Front 53

How is induration measured?

Back 53

in millimeters at its widest transverse diameter ( across the arm )

Front 54

Where is the test result entered in the medical treatment record?

Back 54

Under sensitivity tests, SF 601

Front 55

How must the test result be entered in the medical record?

Back 55

Date, type of tuberculin and its strength, and the diameter of induration in milimeters, written by hand, do not use rubber stamps or automatic imprinting devices

Front 56

How must the complete absence of induration be entered on the SF 601?

Back 56

Zero mm

Front 57

What must be done if a person returns more than 72 hours, but before the 10th day, after ppd application and the induration is 15 mm or greater?

Back 57

Reactor. Enter the induration and the time interval since test application on the SF 601. Manage the person as a TB reactor per evaluation and preventive therapy ( Chemoprophylaxis) of Tuberculin reators

Front 58

What medical conditions have been reported to increase the risk of TB?

Back 58

Silicosis
gastrectomy
jejeunoileal bypass
weight of 10 percent or more below ideal body weight
chronic renal failure
conditions requiring corticosteroid therapy or other immuno-suppressive therapy
hemaatologic disorders
leukemeia

Front 59

What is the antibiotic regimen of choice for TB preventive therapy?

Back 59

INH in oral daily dose of 300 mg for adults and 10 mg/kg.
not to exceed 300 mg for childern

Front 60

how is TB transmitted?

Back 60

small airborne droplets or droplet nuclei from person to person in close contact or ventillation systems

Front 61

Which hospitals are designated to act as contact points for pulmonary medicine or infectious disease consultation and patient transfer if needed?

Back 61

NAVHOSP Oakland, CA
NAVHOSP Portsmouth, VA
NAVHOSP san dieggo, CA
NAVHOSP Bethesda, MD

Front 62

What actions must be taken upon discovery of an active case of TB disease in the command?

Back 62

Initiate disease alert report (MED 6220-3)
Locate patients close contacts
screen contacts, and screen 3 months later
maintain records of summary results
evaluate for secondary cases of TB disease

Front 63

true or false.. Baseline liver function tests are not required for INH recipients under 35?

Back 63

True, but they should be done clinically if indicated

Front 64

What are contradindications to prevent therapy with INH?

Back 64

previous history of INH associated liver injury
history of a severe adverse reaction to INH
acute or active liver disease of any etiology

Front 65

How long should TB reactors with HIV infection and persons with stable abnormal chest radiographys consistent with past TB recieve INH therapy?

Back 65

12 months of continuous therapy with INH