1.
Which of the following are risk factors for drug resistance?
Correct Answer(s)
B. Immigration from parts of the world with a high prevalence of drug resistant TB
C. Close and prolonged contact with individuals with drug-resistant strains
D. Unsuccessful previous therapy
E. Patient non compliance
Explanation
Overuse of antibiotics can contribute to the development of drug resistance as it increases the selective pressure on bacteria to evolve resistance. Immigration from parts of the world with a high prevalence of drug resistant TB can introduce drug-resistant strains into a new population. Close and prolonged contact with individuals with drug-resistant strains can increase the risk of transmission and acquisition of drug-resistant bacteria. Unsuccessful previous therapy may indicate that the patient has already been exposed to drug-resistant strains. Patient non-compliance with medication regimens can lead to inadequate drug levels in the body, promoting the development of drug resistance.
2.
A patient presents with slowly progressive constitutional symptoms of fever, malaise, anorexia, weight loss, fever, and night sweats. After further evaluation, you discover that the patient has had a chronic cough for 25 days. What diagnosis are these symptoms consistent with?
Correct Answer
C. Tuberculosis
Explanation
The patient's presentation of slowly progressive constitutional symptoms such as fever, malaise, anorexia, weight loss, fever, and night sweats, along with a chronic cough for 25 days, is consistent with the diagnosis of tuberculosis. Tuberculosis is an infectious disease caused by the bacteria Mycobacterium tuberculosis, which primarily affects the lungs but can also spread to other parts of the body. The chronic cough and constitutional symptoms are common manifestations of tuberculosis.
3.
T/F Blood-streaked sputum is the most common presenting symptom of TB patients.
Correct Answer
B. False
Explanation
it is common, but significant hemoptysis is rarely a presenting sx
4.
T/F There are no physical exam findings specific for TB.
Correct Answer
A. True
Explanation
There are no physical exam findings specific for TB. This means that during a physical examination, a healthcare provider cannot identify any specific signs or symptoms that are solely indicative of tuberculosis. Other diagnostic tests, such as imaging or laboratory tests, are required to confirm the presence of TB.
5.
What is the most accurate diagnostic method for TB?
Correct Answer
C. Culture of sputum, CSF, or gastric contents
Explanation
The most accurate diagnostic method for TB is the culture of sputum, CSF, or gastric contents. This method involves taking samples of sputum (mucus), cerebrospinal fluid (CSF), or gastric contents and culturing them in a laboratory to identify the presence of Mycobacterium tuberculosis, the bacteria that causes TB. Culturing allows for the growth and identification of the bacteria, providing a definitive diagnosis. Other methods, such as microscopy or molecular tests, may be used initially for screening, but culture is considered the gold standard for accurate diagnosis.
6.
Definitive diagnosis depends on the recovery of M. tuberculosis from cultures or identification of the organism by DNA or RNA amplification techniques. How many consecutive morning sputum specimens are advised?
Correct Answer
C. Three
Explanation
The correct answer is three. This is because the definitive diagnosis of tuberculosis relies on the recovery of M. tuberculosis from cultures or the identification of the organism through DNA or RNA amplification techniques. To increase the chances of detecting the bacteria, it is advised to collect three consecutive morning sputum specimens. This allows for a higher likelihood of capturing the bacteria in the samples and confirming the diagnosis.
7.
T/F Acid-fast bacilli on sputum smear confirm the diagnosis of TB.
Correct Answer
B. False
Explanation
Acid fast bacilli may represent saprophytic non-tuberculosis mycobacteria that may colonize the airways
8.
T/F Cultures grown on solid medium may take 12 weeks to identify, whereas, liquid medium may allow detection of mycobacteria in several days
Correct Answer
A. True
Explanation
Cultures grown on solid medium may take 12 weeks to identify because the growth of mycobacteria is slow and requires a longer incubation period. On the other hand, liquid medium allows for faster detection of mycobacteria within several days, as it provides a more favorable environment for their growth and multiplication. Therefore, the statement is true.
9.
What does this x ray show? Pick two
Correct Answer(s)
B. Small homogenous infiltrates, hilar and paratracheal lympH node enlargement, and segmental atelectaisis
C. Righ upper lobe cavitation with parenchymal involvement which is a classic indicator of progressive primary tuberculosis
Explanation
The x-ray shows small homogenous infiltrates, hilar and paratracheal lymph node enlargement, and segmental atelectasis. Additionally, it also shows right upper lobe cavitation with parenchymal involvement, which is a classic indicator of progressive primary tuberculosis.
10.
T/F A patient with a positive TB skin test is carrying the active infection?
Correct Answer
B. False
Explanation
The test does not distinguish between active and latent infections rather it identifies individuals who have been infected with M.tuberculosis
11.
Which of the following is considered the preferred method of skin testing?
Correct Answer
C. Mantoux test
Explanation
The Mantoux test is considered the preferred method of skin testing. It is a type of tuberculin skin test used to detect tuberculosis (TB) infection. The test involves injecting a small amount of purified protein derivative (PPD) into the skin of the forearm. After 48-72 hours, the healthcare provider checks for a raised, red bump at the injection site. The size of the bump helps determine if the person has been exposed to TB. The Mantoux test is widely used because it is simple, reliable, and provides accurate results in diagnosing TB infection.