TB Treatment
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Questions and Answers

What is the outcome for a patient whose sputum smear or culture is POSITIVE at 5 months during treatment?

  • Assigned as lost to follow up
  • Assigned as treatment failed (correct)
  • Assigned as not evaluated
  • Assigned as treatment succeeded

    • In which scenario is a patient assigned as 'lost to follow up'?

  • A patient who dies during the course of treatment
  • A patient whose treatment is interrupted for 2 consecutive months (correct)
  • A patient diagnosed with active TB but not started on treatment
  • A patient whose follow-up sputum examination was not done

    • What is the assigned outcome for a patient who exhibits severe uncontrolled adverse drug reactions?

  • Treatment succeeded
  • Not evaluated
  • Treatment failed (correct)
  • Lost to follow up

    • What should be the assigned outcome for a patient with evidence of additional acquired resistance during treatment?

    <p>Treatment failed</p> Signup and view all the answers

    What happens to a patient for whom no treatment outcome has been assigned due to transfer to another facility?

    <p>Assigned as not evaluated</p> Signup and view all the answers

    At what age should TB patients be screened for diabetes?

    <p>25 years old</p> Signup and view all the answers

    What is the treatment regimen labeled as Regimen 1 for TB?

    <p>2HRZE/4HR</p> Signup and view all the answers

    Who qualifies to receive Regimen 2 of TB treatment?

    <p>New EPTB of CNS with MTB RIF sensitive</p> Signup and view all the answers

    What is Provider-initiated counselling and testing (PICT) primarily focused on?

    <p>HIV testing and counseling for patients</p> Signup and view all the answers

    If a child with TB has an HIV positive mother, what action should be taken?

    <p>Offer testing for HIV</p> Signup and view all the answers

    For a person weighing 38-54 kg, how many tablets should be administered per day for the regimen 2HRZE/4HR?

    <p>3 tablets</p> Signup and view all the answers

    At what age do you provide PICT to all TB patients?

    <p>15 years old</p> Signup and view all the answers

    What is the daily tablet dosage for a TB patient weighing more than 70 kg on the regimen 2HRZE/4HR?

    <p>5 tablets</p> Signup and view all the answers

    What is the appropriate management for jaundice due to hepatitis when caused by HRZ drugs?

    <p>Stop HRZ drugs and refer to a specialist</p> Signup and view all the answers

    Which anti-TB drug is responsible for causing orange-colored urine?

    <p>Rifampicin</p> Signup and view all the answers

    What is the most effective management for burning sensations in the feet due to peripheral neuropathy from Isoniazid?

    <p>Administer Pyridoxine (Vitamin B6)</p> Signup and view all the answers

    What is the management step for arthralgia caused by hyperuricemia from Pyrazinamide?

    <p>Provide aspirin or NSAIDs</p> Signup and view all the answers

    After how many months should the first sputum follow-up be scheduled for a newly diagnosed CDTB patient?

    <p>2 months</p> Signup and view all the answers

    What is the next step if the smear microscopy result is positive at the end of the intensive phase?

    <p>Request for Xpert MTB/Rif and proceed with continuation phase</p> Signup and view all the answers

    Which anti-TB drug is most likely to cause psychosis and convulsions?

    <p>Isoniazid</p> Signup and view all the answers

    What is the management for the impairment of visual acuity caused by Ethambutol?

    <p>Stop Ethambutol and refer to an ophthalmologist</p> Signup and view all the answers

    If a smear microscopy follow-up result is negative after treatment interruption of less than 1 month, what should be done?

    <p>Continue treatment and prolong to compensate for missed doses</p> Signup and view all the answers

    Which drug causes flu-like symptoms including fever and muscle pains?

    <p>Rifampicin</p> Signup and view all the answers

    When can a clinically diagnosed PTB patient be cleared for work?

    <p>After 1 week of uninterrupted treatment</p> Signup and view all the answers

    What should be done if treatment was interrupted for more than 1 month but less than 2 months?

    <p>Do smear microscopy first</p> Signup and view all the answers

    Which anti-TB drug poses the greatest risk of adverse drug reactions?

    <p>Rifampicin</p> Signup and view all the answers

    In case of oliguria or albuminuria due to renal disorder caused by Rifampicin, what is the management?

    <p>Stop Rifampicin and refer to a specialist</p> Signup and view all the answers

    What is the outcome for a patient whose treatment was interrupted for more than 2 months?

    <p>Lost to follow up</p> Signup and view all the answers

    What is the outcome if a patient shows no evidence of clinical improvement during treatment, and follow-up sputum examination was not done?

    <p>Treatment failed</p> Signup and view all the answers

    What should be the assigned outcome for a patient diagnosed with active TB who has not yet begun treatment?

    <p>Lost to follow up</p> Signup and view all the answers

    If a patient's sputum smear is positive at 5 months or later during treatment, what is this considered?

    <p>Treatment failed</p> Signup and view all the answers

    What is assigned to a patient who dies during the course of TB treatment?

    <p>Died</p> Signup and view all the answers

    What is the correct tablet dosage for a TB patient weighing between 55-70 kg on the regimen 2HRZE/4HR?

    <p>4 tablets</p> Signup and view all the answers

    Which of the following groups of patients are eligible for Regimen 2 of TB treatment?

    <p>New EPTB of CNS with MTB RIF sensitive</p> Signup and view all the answers

    What is the primary purpose of Provider-initiated counselling and testing (PICT) for TB patients?

    <p>To screen for HIV</p> Signup and view all the answers

    For a TB patient weighing around 25-37 kg, how many tablets should they receive per day for the regimen 2HRZE/4HR?

    <p>2 tablets</p> Signup and view all the answers

    At what age should all TB patients start receiving PICT?

    <p>15 years old and above</p> Signup and view all the answers

    Which of the following accurately describes a characteristic of Regimen 1 in TB treatment?

    <p>It consists of 2HRZE followed by 4HR</p> Signup and view all the answers

    What should be done if a child with TB shows signs of having an HIV positive mother?

    <p>Offer testing for HIV</p> Signup and view all the answers

    Which classification of TB patients is indicated for treatment regimen 2HRZE/10HR?

    <p>New EPTB involving CNS</p> Signup and view all the answers

    Which anti-TB drug is associated with causing both flu-like symptoms and orange colored urine?

    <p>Rifampicin</p> Signup and view all the answers

    What is the appropriate management if a patient experiences jaundice due to hepatitis from HRZ drugs?

    <p>Stop the anti-TB drugs and refer to a specialist</p> Signup and view all the answers

    When should a patient undergoing anti-TB treatment be scheduled for monthly weight checks?

    <p>Monthly throughout the treatment</p> Signup and view all the answers

    Which drug is most likely to cause arthralgia due to hyperuricemia?

    <p>Pyrazinamide</p> Signup and view all the answers

    What is the management protocol if a patient experiences a burning sensation in the feet due to peripheral neuropathy?

    <p>Provide Pyridoxine (Vitamin B6)</p> Signup and view all the answers

    If a smear microscopy follow-up result is found positive after 6 months of treatment, what should be done?

    <p>Stop treatment and declare as treatment failure</p> Signup and view all the answers

    Which anti-TB drug causes impairment of visual acuity and requires referral to an ophthalmologist?

    <p>Ethambutol</p> Signup and view all the answers

    What should be done if treatment is interrupted for more than 1 month but less than 2 months and the smear microscopy result is negative?

    <p>Continue treatment and extend to compensate for missed doses</p> Signup and view all the answers

    What is the management when a patient experiences thrombocytopenia, anemia, and shock due to Rifampicin?

    <p>Stop Rifampicin and refer to a specialist</p> Signup and view all the answers

    At what point in treatment can a patient with clinically diagnosed PTB be cleared for work?

    <p>After 1 week of uninterrupted treatment</p> Signup and view all the answers

    Which anti-TB drug is responsible for causing psychosis and convulsion?

    <p>Isoniazid</p> Signup and view all the answers

    When should sputum follow-up for newly diagnosed BCTB patients be scheduled?

    <p>At the end of the intensive phase, which is the 2nd month</p> Signup and view all the answers

    What does hyperuricemia caused by Pyrazinamide typically result in?

    <p>Joint pain (arthralgia)</p> Signup and view all the answers

    Study Notes

    TB Screening and Treatment Regimens

    • TB patients aged 25 years and older should be screened for diabetes.
    • Regimen 1 for TB treatment is 2HRZE/4HR, targeting new or retreatment pulmonary TB with MTB RIF sensitive or indeterminate.
    • Eligible patients for Regimen 1 include:
      • New or Retreatment pulmonary TB,
      • Extrapulmonary TB except CNS, brain, bones, joints, with MTB RIF sensitive,
      • New PTB with positive SM TB LAMP or clinically diagnosed cases.
    • Regimen 2 for TB treatment is 2HRZE/10HR, specifically for new or retreatment extrapulmonary TB affecting CNS, joints, or bones with MTB RIF sensitive or indeterminate.

    Provider-Initiated Counseling and Testing (PICT)

    • PICT is provided to all TB patients aged 15 years and older.
    • In cases where a child with TB has an HIV-positive mother or HIV symptoms, testing should be offered.

    Medication Dosage Based on Weight

    • For the 2HRZE/4HR regimen:
      • Patients weighing 25-37 kg receive 2 tablets daily.
      • Patients weighing 38-54 kg receive 3 tablets daily.
      • Patients weighing 55-70 kg receive 4 tablets daily.
      • Patients over 70 kg receive 5 tablets daily.

    Follow-Up and Monitoring

    • Follow-up for newly initiated treatment is scheduled 2 weeks after initiation.
    • Subsequent follow-ups occur at least monthly.
    • Patient weight should be monitored monthly.

    Side Effects and Management of Anti-TB Drugs

    • GI intolerance is primarily caused by HRZ drugs (Isoniazid, Rifampicin, Pyrazinamide); management involves administering them at bedtime or with small meals.
    • Skin reactions can occur with any anti-TB drug; antihistamines are recommended for management.
    • Rifampicin causes orange urine; no specific treatment needed, just reassurance.
    • Isoniazid can cause burning sensations in feet due to peripheral neuropathy; treat with Pyridoxine (Vitamin B6) 50-100 mg daily.
    • Pyrazinamide is associated with arthralgia due to hyperuricemia; manage with aspirin or NSAIDs.
    • Rifampicin can lead to flu-like symptoms; manage with antipyretics.
    • Jaundice can result from HRZ drugs; management requires stopping the drugs and referring to specialists.
    • Ethambutol may impair visual acuity; discontinue and refer to an ophthalmologist.
    • Oliguria or albuminuria is caused by Rifampicin; stop the drug and refer to specialists.
    • Isoniazid may lead to psychosis and convulsions; halt the medication and refer to specialists.
    • Rifampicin can cause thrombocytopenia, anemia, and shock; stop the drug and refer to specialists.

    Adverse Reactions Overview

    • Rifampicin is known for having the most adverse drug reactions, including:
      • Orange-colored urine
      • Flu-like symptoms
      • Oliguria and albuminuria
      • Thrombocytopenia and anemia

    Sputum Follow-Up

    • Sputum follow-up for newly diagnosed CDTB and BDTB occurs at the end of the intensive phase (2 months).
    • Follow-up sputum tests are conducted only if initial tests are positive.
    • If smear microscopy results are negative during follow-up, continue treatment as prescribed.

    Managing Treatment Interruptions

    • If treatment is interrupted for less than 1 month, continue treatment, extending to compensate for missed doses.
    • If interrupted for more than 1 month but less than 2 months, perform smear microscopy; negative results allow you to continue with doses.
    • A positive smear during interruptions of more than 1 month necessitates continuation and compensation, while exceeding 5 months results in treatment failure.

    Treatment Outcome Assignments

    • Treatment failure is defined as positive sputum at or beyond 5 months.
    • A patient who dies during treatment is recorded as "died."
    • Patients not started on treatment or not evaluated due to transfers have outcomes classified as "lost to follow up" or "not evaluated" respectively.

    TB Screening and Treatment Regimens

    • TB patients aged 25 years and older should be screened for diabetes.
    • Regimen 1 for TB treatment is 2HRZE/4HR, targeting new or retreatment pulmonary TB with MTB RIF sensitive or indeterminate.
    • Eligible patients for Regimen 1 include:
      • New or Retreatment pulmonary TB,
      • Extrapulmonary TB except CNS, brain, bones, joints, with MTB RIF sensitive,
      • New PTB with positive SM TB LAMP or clinically diagnosed cases.
    • Regimen 2 for TB treatment is 2HRZE/10HR, specifically for new or retreatment extrapulmonary TB affecting CNS, joints, or bones with MTB RIF sensitive or indeterminate.

    Provider-Initiated Counseling and Testing (PICT)

    • PICT is provided to all TB patients aged 15 years and older.
    • In cases where a child with TB has an HIV-positive mother or HIV symptoms, testing should be offered.

    Medication Dosage Based on Weight

    • For the 2HRZE/4HR regimen:
      • Patients weighing 25-37 kg receive 2 tablets daily.
      • Patients weighing 38-54 kg receive 3 tablets daily.
      • Patients weighing 55-70 kg receive 4 tablets daily.
      • Patients over 70 kg receive 5 tablets daily.

    Follow-Up and Monitoring

    • Follow-up for newly initiated treatment is scheduled 2 weeks after initiation.
    • Subsequent follow-ups occur at least monthly.
    • Patient weight should be monitored monthly.

    Side Effects and Management of Anti-TB Drugs

    • GI intolerance is primarily caused by HRZ drugs (Isoniazid, Rifampicin, Pyrazinamide); management involves administering them at bedtime or with small meals.
    • Skin reactions can occur with any anti-TB drug; antihistamines are recommended for management.
    • Rifampicin causes orange urine; no specific treatment needed, just reassurance.
    • Isoniazid can cause burning sensations in feet due to peripheral neuropathy; treat with Pyridoxine (Vitamin B6) 50-100 mg daily.
    • Pyrazinamide is associated with arthralgia due to hyperuricemia; manage with aspirin or NSAIDs.
    • Rifampicin can lead to flu-like symptoms; manage with antipyretics.
    • Jaundice can result from HRZ drugs; management requires stopping the drugs and referring to specialists.
    • Ethambutol may impair visual acuity; discontinue and refer to an ophthalmologist.
    • Oliguria or albuminuria is caused by Rifampicin; stop the drug and refer to specialists.
    • Isoniazid may lead to psychosis and convulsions; halt the medication and refer to specialists.
    • Rifampicin can cause thrombocytopenia, anemia, and shock; stop the drug and refer to specialists.

    Adverse Reactions Overview

    • Rifampicin is known for having the most adverse drug reactions, including:
      • Orange-colored urine
      • Flu-like symptoms
      • Oliguria and albuminuria
      • Thrombocytopenia and anemia

    Sputum Follow-Up

    • Sputum follow-up for newly diagnosed CDTB and BDTB occurs at the end of the intensive phase (2 months).
    • Follow-up sputum tests are conducted only if initial tests are positive.
    • If smear microscopy results are negative during follow-up, continue treatment as prescribed.

    Managing Treatment Interruptions

    • If treatment is interrupted for less than 1 month, continue treatment, extending to compensate for missed doses.
    • If interrupted for more than 1 month but less than 2 months, perform smear microscopy; negative results allow you to continue with doses.
    • A positive smear during interruptions of more than 1 month necessitates continuation and compensation, while exceeding 5 months results in treatment failure.

    Treatment Outcome Assignments

    • Treatment failure is defined as positive sputum at or beyond 5 months.
    • A patient who dies during treatment is recorded as "died."
    • Patients not started on treatment or not evaluated due to transfers have outcomes classified as "lost to follow up" or "not evaluated" respectively.

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    Description

    Test your knowledge on tuberculosis treatment protocols, particularly focusing on patient eligibility and screening for diabetes. This quiz covers key aspects of Regimen 1 for TB patients and their requirements. Perfect for healthcare professionals and students in medical fields.

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