Cdc Tb

Front 1

Select all that apply.

Which of the following factors fueled the resurgence of TB in the late 1980s and early 1990s?
a) The onset of the HIV epidemic
b) Spread of TB in congregate settings
c) Inadequate funding for TB control
d) Lack of reporting new cases
e) Immigration from countries where TB was common

Back 1

a) The onset of the HIV epidemic
b) Spread of TB in congregate settings
c) Inadequate funding for TB control
e) Immigration from countries where TB was common

Front 2

During 1992-2002, the overall decrease in TB cases reflected the substantial decline in cases among US-born persons and a small decline in the number of cases among foreign-born persons.
a) True
b) False

Back 2

True. During 1992-2002, the overall decrease in TB cases reflected the substantial decline in cases among US-born persons and a small decline in the number of cases among foreign-born persons.

Front 3

Select all that apply.

The Institute of Medicine report recommended which of the following strategies to make TB elimination a reality in the U.S.?
a) Develop new tools for TB diagnosis, treatment, and prevention
b) Increase efforts to test all citizens
c) Increase efforts to fight the global TB epidemic
d) Mobilize public support for TB elimination

Back 3

a) Develop new tools for TB diagnosis, treatment, and prevention
c) Increase efforts to fight the global TB epidemic
d) Mobilize public support for TB elimination

Front 4

Select all that apply.

Which of the following statements are true?
a) TB cases are reported in every state
b) 2002 marked the lowest number of reported TB cases since the start of national reporting
c) The 2000 national strategic plan for TB elimination interim goal of 3.5 cases per 100,000 population was met in 2002
d) There was a resurgence of TB cases from 1985 through 1992

Back 4

a) TB cases are reported in every state
b) 2002 marked the lowest number of reported TB cases since the start of national reporting
d) There was a resurgence of TB cases from 1985 through 1992

Front 5

Select all that apply.

Which statements describe how TB is transmitted?
a) Close contacts of those with infectious TB are at the highest risk of becoming infected.
b) M. tuberculosis is expelled when a person with latent TB coughs, sneezes, speaks or sings.
c) TB is spread by droplet nuclei containing tubercle bacilli.
d) TB can be spread by sharing the same eating utensils.

Back 5

a) Close contacts of those with infectious TB are at the highest risk of becoming infected.
c) TB is spread by droplet nuclei containing tubercle bacilli.

Front 6

Select all that apply.

Persons at increased risk for drug resistance include:
a) Persons who have a history of treatment with TB drugs
b) Contacts of persons known to have drug-resistant TB
c) Persons who are infected with HIV
d) Foreign-born persons from areas where the prevalence of drug-resistant TB is high
e) Persons with recent infection with M. tuberculosis (within the past two years)

Back 6

a) Persons who have a history of treatment with TB drugs
b) Contacts of persons known to have drug-resistant TB
d) Foreign-born persons from areas where the prevalence of drug-resistant TB is high
e) Persons with recent infection with M. tuberculosis (within the past two years)

Front 7

In the classification system for TB, where would you classify a patient who has a positive reaction to the tuberculin skin test and radiographic evidence of current disease?
a) Class 1
b) Class 2
c) Class 3
d) Class 4
e) Class 5

Back 7

c) Class 3 - M. tuberculosis cultured (if done)
Clinical, bacteriological, or radiographic evidence of current disease

Front 8

Select the correct statement(s):
a) When reading a TST, erythema should be measured if induration is not present.
b) TST should be read 48 to 72 hours after the injection by a trained health care worker.
c) Even though the Quanti-FERON TB (QFT) test and Mantoux tuberculin skin test (TST) are not interchangeable, they essentially measure the same components of the immunologic response.
d) TST interpretation depends on: the measurement in centimeters (cm) of the induration and the person’s access to medical care.
e) QFT should not be considered for initial and serial testing of persons with an increased risk of TB infection.

Back 8

b) TST should be read 48 to 72 hours after the injection by a trained health care worker.

Front 9

Select the correct answer.

The use of anergy testing in conjunction with tuberculin skin testing is routinely recommended for screening programs for M. tuberculosis infection conducted among HIV-infected persons in the United States.
a) True
b) False

Back 9

False - The use of anergy testing in conjunction with tuberculin skin testing is not routinely recommended for screening programs for M. tuberculosis infection conducted among HIV-infected persons in the United States.

Front 10

Select all that apply.

A TST reaction that is greater than or equal to 5 mm of induration is interpreted as positive in which of the following groups?
a) Persons with fibrotic changes on chest radiograph consistent with old healed TB
b) Persons with no known risk factors for TB
c) HIV-negative persons
d) Recent contacts of TB case
e) Patients with organ transplants and other immunosuppressed patients

Back 10

The correct answers are a, d, and e.
a) Persons with fibrotic changes on chest radiograph consistent with old healed TB
d) Recent contacts of TB case
e) Patients with organ transplants and other immunosuppressed patients

Front 11

Select all that apply.

Which of the following is a correct statement about two-step testing?
a) Two-step testing should be used for the initial skin testing of adults who will be retested periodically.
b) Two-step testing is used to reduce the likelihood that a boosted reaction will be misinterpreted as a recent infection.
c) Delayed-type hypersensitivity to tuberculin may wane over the years and a skin test may boost the ability to react to tuberculin, causing a positive reaction to subsequent tests.
d) Two-step testing should be used for all school-aged children.

Back 11

The correct answer is A, B, and C
a) Two-step testing should be used for the initial skin testing of adults who will be retested periodically.
b) Two-step testing is used to reduce the likelihood that a boosted reaction will be misinterpreted as a recent infection.
c) Delayed-type hypersensitivity to tuberculin may wane over the years and a skin test may boost the ability to react to tuberculin, causing a positive reaction to subsequent tests.

Front 12

Select all that apply.

Which of the following confirms a diagnosis of TB?
a) Chest radiograph
b) Detection of acid-fast bacilli in smear examination
c) Positive tuberculin skin test
d) Positive culture of M. tuberculosis

Back 12

The correct answer is d. A positive culture of M. tuberculosis confirms a diagnosis of TB.

Front 13

Select all that apply.

Identify the correct statement(s).
a) A negative reaction to a TST excludes the diagnosis of TB.
b) Symptoms of pulmonary TB depend on the site affected.
c) TB can be ruled out on the basis of a physical evaluation.
d) When diagnosing TB, clinicians should consider demographic factors and medical conditions.

Back 13

The correct answer is d. When diagnosing TB, clinicians should consider demographic factors and medical conditions.

Front 14

Select all that apply.

Select the correct statement(s) concerning chest radiographs.
a) Abnormalities are often seen in apical or posterior segments of upper lobe.
b) Cannot confirm diagnosis of TB.
c) May have unusual appearance in HIV-infected persons.
d) Abnormalities often seen in superior segments of lower lobe.
e) Old healed TB does not appear.

Back 14

The correct answers are a, b, c, and d. Abnormalities are often seen in apical or posterior segments of the upper lobe and in superior segments of the lower lobe. Chest radiographs cannot confirm diagnosis of TB and may have an unusual appearance in HIV-infected persons.

Front 15

Select all that apply.

Genotyping is used to:
a) Facilitate tracking of TB transmission during outbreaks
b) Investigate lab contamination
c) Test for resistance to anti-tuberculosis medications
d) Identify specific strains of M. tuberculosis
e) Test for culture conversion

Back 15

The correct answers are a, b, and d. Genotyping is used to facilitate tracking of TB transmission during outbreaks, investigate lab contamination, and identify specific strains of M. tuberculosis.

Front 16

Jan Smith is a pregnant 40-year-old mother of two small children. Jan was identified by the local health department as a close contact to a person with active fully drug-susceptible TB disease. Her tuberculin skin test was measured at 6 mm of induration. Her chest radiograph is negative for active TB disease and her HIV status is unknown.

Should Jan be treated for LTBI? If yes, what is the preferred regimen?
a) A 4-month regimen of RIF
b) A 9-month regimen of INH
c) A 2-month regimen of RIF and PZA
d) Jan does not appear to need treatment for LTBI

Back 16

The correct answer is b. Jan should be treated for LTBI with a 9-month regimen of INH.

Front 17

Select all that apply.

Baseline laboratory testing is indicated at the start of treatment for LTBI for which of the following groups?
a) Persons whose initial evaluation suggests a liver disorder
b) Contacts of multi-drug resistant TB
c) All patients who will be placed on LTBI
d) Pregnant women
e) HIV-infected persons

Back 17

The correct answers are a, d, and e. Baseline laboratory testing is indicated at the start of LTBI treatment for persons whose initial evaluation suggests a liver disorder, pregnant women, and HIV-infected persons.

Front 18

Select all that apply.

Which of the following are first-line anti-TB drugs?
a) Isoniazid
b) Rifampin
c) Streptomycin
d) Pyrazinamide
e) Ethambutol

Back 18

The correct answers are a, b, d, and e. Isoniazid, rifampin, pyrazinamide, and ethambutol are first-line anti-TB drugs.

Front 19

Select all that apply.

When TB treatment is initiated, which of the following baseline examinations should be conducted?
a) Platelet count
b) Testing of visual acuity and color vision when EMB is to be used
c) Measurements of aminotransferases
d) Glucose testing
e) Serologic testing for people at risk for hepatitis A

Back 19

The correct answers are a, b, and c. When treatment is initiated, platelet count, testing of visual acuity and color vision when EMB is to be used, and measurements of aminotransferases are baseline examinations that should be conducted.

Front 20

Select all the apply.

Which of the following describes directly observed therapy (DOT)?
a) A public health worker gives the patient a bottle of pills monthly.
b) A designated individual watches the patient swallow every dose of the prescribed medicine.
c) A public health worker counts the remaining pills in the medication bottles.
d) All of the above.

Back 20

The correct answer is b. Directly observed therapy (DOT) occurs when a designated individual watches the patient swallow every dose of the prescribed medicine.

Front 21

Since a major concern in treating TB in the setting of HIV infection is the interaction of rifampin with anti-retroviral agents, which drug may be used as a substitute for rifampin?
a) Rifamycin
b) Isoniazid
c) Rifabutin
d) Rifapentine

Back 21

The correct answer is c. Since a major concern in treating TB in the setting of HIV infection is the interaction of rifampin with anti-retroviral agents, rifampin may be substituted with rifabutin.

Front 22

Select all that apply.

The treatment for pregnant women with pulmonary TB should exclude:
a) Pyrazinamide
b) Ethambutol
c) Streptomycin
d) Pyridoxine

Back 22

The correct answers are a and c. The initial treatment for pregnant women with pulmonary TB should exclude pyrazinamide and streptomycin.

Front 23

Select all that apply.

Monitoring for adverse reactions to TB treatment include:
a) Routine monitoring of liver or renal function in the absence of baseline abnormalities.
b) Monthly repeat testing of visual acuity and color vision for patients receiving EMB.
c) Clinical evaluations once every three months.
d) Baseline measurements such as serologic testing and CD4+ lymphocyte count measurement for HIV-positive persons.

Back 23

The correct answers are b and d. Monitoring for adverse reactions include monthly repeat testing of visual acuity and color vision for patients receiving EMB and baseline measurements such as serologic testing and CD4+ lymphocyte count measurement for HIV-positive persons.

Front 24

Select all that apply.

Identify common adverse reactions to TB treatment:
a) Neck pain
b) Hepatitis
c) Abdominal pain
d) Headaches
e) Drug fever

Back 24

The correct answers are b, c, and e. Common adverse reactions to TB treatment include hepatitis, abdominal pain, and drug fever.

Front 25

Select all that apply.

When treatment for TB disease is initiated, which of the following baseline examinations should be conducted?
a) Platelet count
b) Testing of visual acuity and color vision when EMB is to be used
c) Measurements of aminotransferases
d) Glucose testing
e) Serologic testing for people at risk for hepatitis A

Back 25

The correct answers are a, b, and c.
a) Platelet count
b) Testing of visual acuity and color vision when EMB is to be used
c) Measurements of aminotransferases

Front 26

Select all that apply.

All patients with confirmed drug-susceptible TB disease should be considered infectious until they:
a) Are on adequate therapy
b) Demonstrate clinical improvement
c) Have had 3 consecutive negative sputum smear results from specimens collected on different days

Back 26

The correct answers are a, b, and c. All patients with confirmed drug-susceptible TB disease should be considered infectious until they are on adequate therapy, demonstrate clinical improvement, and have had 3 consecutive negative sputum smear results from specimens collected on different days.

Front 27

Select the correct answer.

TST in persons vaccinated with BCG should be interpreted using the same criteria for those not BCG-vaccinated.
a) True
b) False

Back 27

The correct answer is a. TST in persons vaccinated with BCG should be interpreted using the same criteria for those not BCG-vaccinated.

Front 28

Select all that apply.

Which of the following have the primary responsibility for preventing and controlling TB?
a) Health care providers offering TB services in a private clinic
b) State and local health departments
c) Health care providers offering TB services in a high risk community
d) Hospitals

Back 28

The correct answer is b. State and local health departments have the primary responsibility for preventing and controlling TB.