Tuberculosis Epidemiology and Risk Factors Quiz
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Questions and Answers

What is the primary mode of transmission for tuberculosis?

  • Inhaling organism within aerosol droplets expelled by an individual coughing with active disease (correct)
  • Ingestion of contaminated food or water
  • Direct contact with infected bodily fluids
  • Transmission through insect vectors

Which group of individuals is at a higher risk of developing active tuberculosis?

  • Health care workers and prison guards (correct)
  • Retail workers and chefs
  • Office workers and teachers
  • Athletes and fitness instructors

What is the immune response to Mycobacterium tuberculosis infection?

  • Neutrophils and natural killer cells attack the infected cells
  • T cells and macrophages surround the organism to form granulomas (correct)
  • B cells produce antibodies to directly attack the bacteria
  • Eosinophils and basophils encapsulate the bacteria

What is the characteristic feature of Mycobacterium tuberculosis when stained?

<p>Acid-fast bacilli (B)</p> Signup and view all the answers

Which of the following is the recommended treatment duration for latent tuberculosis infection in a patient with a positive tuberculin skin test and a negative chest X-ray?

<p>Isoniazid daily for 9 months (D)</p> Signup and view all the answers

In which scenario is multidrug-resistant tuberculosis defined?

<p>Resistance to isoniazid and rifampin (B)</p> Signup and view all the answers

What is the recommended initial drug regimen for the treatment of active tuberculosis?

<p>Isoniazid, rifampin, ethambutol, and pyrazinamide for 2 months, followed by isoniazid and rifampin for 4 months (B)</p> Signup and view all the answers

What is the primary purpose of the tuberculin skin test (TST)?

<p>To screen for latent tuberculosis infection (C)</p> Signup and view all the answers

What is the characteristic histologic hallmark of tuberculosis?

<p>Caseating granulomas (B)</p> Signup and view all the answers

In individuals with no known risk factors for tuberculosis, what tuberculin skin test (TST) result would prompt further evaluation?

<p>≥ 15 mm (A)</p> Signup and view all the answers

What is the recommended treatment duration for isoniazid prophylaxis in individuals who tested negative in the past but are now positive for tuberculosis with known or unknown exposure?

<p>6-12 months (A)</p> Signup and view all the answers

What is the primary mode of prevention for tuberculosis?

<p>Reduce risk factors (C)</p> Signup and view all the answers

Which of the following is a common site for extrapulmonary tuberculosis?

<p>Central nervous system (D)</p> Signup and view all the answers

What is the definitive diagnostic method for tuberculosis?

<p>Identification of Mycobacterium tuberculosis in sputum gram stain (C)</p> Signup and view all the answers

Which of the following is a key characteristic of Mycobacterium tuberculosis?

<p>High lipid content (C)</p> Signup and view all the answers

What is the primary immune response to Mycobacterium tuberculosis infection?

<p>T cells and macrophages surrounding the organism to form granuloma (D)</p> Signup and view all the answers

What is the mode of transmission for tuberculosis?

<p>Inhaling organism within aerosol droplets expelled by an individual coughing with active disease (D)</p> Signup and view all the answers

Which of the following is a common symptom of tuberculosis?

<p>Drenching night sweats (A)</p> Signup and view all the answers

What percentage of individuals infected with tuberculosis will develop the disease?

<p>10% (C)</p> Signup and view all the answers

Which of the following is a common risk factor for tuberculosis?

<p>Substance abuse (C)</p> Signup and view all the answers

Explain the term 'disease of poverty' in the context of tuberculosis.

<p>Tuberculosis is referred to as a 'disease of poverty' because it disproportionately affects individuals living in poverty due to factors such as poor living conditions, malnutrition, lack of access to healthcare, and overcrowding.</p> Signup and view all the answers

Describe the pathophysiology of Mycobacterium tuberculosis infection in the human body.

<p>Mycobacterium tuberculosis, with its high lipid content, is an acid-fast bacillus that is inhaled into the lungs and primarily affects areas with increased airflow. It leads to symptoms such as dry cough, fever, chills, drenching night sweats, anorexia, and weight loss. The bacilli multiply in macrophages, move through the lymph system and blood, and can lead to extrapulmonary tuberculosis affecting various organs.</p> Signup and view all the answers

What is the difference between primary TB and latent TB?

<p>Primary TB occurs in 5% of exposed individuals and results in active TB, while latent TB is present in 95% of infected individuals who contain the bacterium without being symptomatic or infectious.</p> Signup and view all the answers

What are the common risk factors associated with the development of tuberculosis?

<p>Common risk factors for tuberculosis include being immunosuppressed (e.g., due to HIV, cancer, or steroid use), occupational exposure (e.g., healthcare workers, prison guards), substance abuse (e.g., alcohol), diabetes, malnutrition, and living in areas with poor medical care.</p> Signup and view all the answers

Describe the immune response to Mycobacterium tuberculosis infection.

<p>The immune response to Mycobacterium tuberculosis infection involves T cells and macrophages surrounding the organism to form granulomas. In latent TB, 95% of individuals contain the bacterium without being symptomatic or infectious, while in active TB, the immune response may not contain the infection.</p> Signup and view all the answers

Explain the diagnostic studies used for tuberculosis and the definitive diagnostic methods.

<p>Diagnostic studies for tuberculosis include CXR/chest CT, TB skin test, QuantiFERON GOLD blood test, serial sputum smears and cultures, bronchoscopy, and biopsy. The definitive diagnostic methods include the detection of acid-fast bacilli on sputum gram stain and the identification of M. tuberculosis.</p> Signup and view all the answers

What are the common signs and symptoms of tuberculosis? Describe the PE findings associated with the disease.

<p>Common signs and symptoms of tuberculosis include dry cough, productive cough with or without hemoptysis, fever, chills, drenching night sweats, anorexia, and weight loss. Physical examination findings may include a chronically ill and malnourished appearance, lymphadenopathy, hepatosplenomegaly, hypoxia, and cachexia.</p> Signup and view all the answers

Explain the concept of extrapulmonary tuberculosis and provide examples of its manifestations.

<p>Extrapulmonary tuberculosis refers to the involvement of organs other than the lungs by M. tuberculosis. Examples of its manifestations include CNS tuberculosis leading to meningitis, lymphatic tuberculosis leading to scrofula, pleural tuberculosis leading to TB pleurisy, and disseminated tuberculosis affecting organs such as the bones, joints, and genitourinary system.</p> Signup and view all the answers

Explain the histologic hallmark of tuberculosis and its significance in diagnosis.

<p>Tuberculosis is characterized by the presence of caseating granulomas, also known as necrotizing granulomas. These granulomas are the histologic hallmark of tuberculosis and are significant in the diagnosis of the disease.</p> Signup and view all the answers

Describe the method and interpretation of the tuberculin skin test (TST) in the diagnosis of tuberculosis.

<p>The tuberculin skin test (TST) involves the intradermal injection of purified protein derivative (PPD) using the Mantoux method. A positive delayed-type hypersensitivity reaction, indicated by an induration size of $≥ 5$ mm, is interpreted as a positive result, suggesting exposure to tuberculosis and the individual's health status.</p> Signup and view all the answers

What is the recommended treatment duration for isoniazid prophylaxis in individuals who tested negative in the past but are now positive for tuberculosis with known or unknown exposure?

<p>The recommended treatment duration for isoniazid prophylaxis in individuals who tested negative in the past but are now positive for tuberculosis with known or unknown exposure is $6-12$ months.</p> Signup and view all the answers

Explain the treatment regimen for active tuberculosis, including the duration and drugs used.

<p>The treatment regimen for active tuberculosis involves a minimum of 2 weeks of therapy with a combination of four drugs: isoniazid, rifampin, ethambutol, and pyrazinamide. After this initial phase, culture and sensitivity testing are performed, and multi-drug therapy is continued for an additional 4 months. The total duration of treatment ranges from 6-9 months.</p> Signup and view all the answers

Describe the diagnostic criteria and treatment regimen for multidrug-resistant tuberculosis.

<p>Multidrug-resistant tuberculosis is defined as resistance to rifampin and isoniazid. The drug regimen for multidrug-resistant tuberculosis is based on the specific drug to which the patient is resistant. Prevention and control measures are essential in managing multidrug-resistant tuberculosis.</p> Signup and view all the answers

Explain the preventive measures for tuberculosis, including primary and secondary prevention strategies.

<p>Primary prevention of tuberculosis involves reducing risk factors and may include vaccination with the bacille Calmette-Guérin (BCG) vaccine. Secondary prevention focuses on identifying and isolating active cases to prevent transmission, as well as providing appropriate treatment to reduce infectivity.</p> Signup and view all the answers

Describe the radiographic findings in primary and reactivation tuberculosis as seen on chest X-rays.

<p>Primary tuberculosis is characterized by enlargement of the hilar and paratracheal lymph nodes, as well as cavitation with progressive disease and segmental atelectasis. Reactivation tuberculosis typically presents with cavitation and opacities in the right upper lobe (RUL), as well as the presence of Ghon and Ranke complexes.</p> Signup and view all the answers

Explain the management considerations for individuals exposed to active tuberculosis and the recommended follow-up guidelines.

<p>Management considerations for individuals exposed to active tuberculosis include screening with the tuberculin skin test (TST) and close follow-up. Those with a TST induration size of $&gt;5$ mm are treated aggressively, and certain groups, such as children, adolescents, and immunocompromised individuals, require specific management and follow-up protocols.</p> Signup and view all the answers

Explain the difference between the treatment regimens for active tuberculosis and latent tuberculosis infection, including the drugs used and the duration of treatment.

<p>The treatment regimen for active tuberculosis involves a minimum of 6 months of therapy with four drugs: isoniazid, rifampin, ethambutol, and pyrazinamide for the first two months, followed by isoniazid and rifampin for an additional 4 months. The treatment regimen for latent tuberculosis infection includes isoniazid daily for 9 months or rifampin daily for 4 months.</p> Signup and view all the answers

Describe the radiographic findings in primary tuberculosis and reactivation tuberculosis as seen on chest X-rays.

<p>Primary tuberculosis is characterized by hilary paratracheal lymph node enlargement, enlargement of lymph nodes of pulmonary hila, and cavitation with progressive disease leading to larger areas of lung tissue death. Reactivation tuberculosis typically presents with cavitation and opacities in the right upper lobe, and the development of Ghon and Ranke complexes, which represent healed primary infection.</p> Signup and view all the answers

Explain the procedure and interpretation of the tuberculin skin test (TST) in the diagnosis of tuberculosis.

<p>The tuberculin skin test involves the intradermal injection of purified protein derivative (PPD) and the measurement of the resulting induration after 48-72 hours. A positive result is indicated by an induration size of 5 mm or greater in individuals with no known risk factors for tuberculosis, 10 mm or greater in recent immigrants, and 15 mm or greater in individuals with no known risk factors for tuberculosis.</p> Signup and view all the answers

Describe the histologic hallmark of tuberculosis and its significance in the diagnosis.

<p>The histologic hallmark of tuberculosis is the presence of caseating granulomas, also known as necrotizing granulomas, in affected tissues. These granulomas are significant in the diagnosis of tuberculosis as they provide evidence of mycobacterial infection and help differentiate tuberculosis from other granulomatous diseases.</p> Signup and view all the answers

Explain the preventive measures for tuberculosis, including primary and secondary prevention strategies.

<p>Primary prevention of tuberculosis involves reducing risk factors and the administration of the Bacillus Calmette-Guérin (BCG) vaccine in countries with a high prevalence of tuberculosis. Secondary prevention strategies include the identification and isolation of active cases, as well as the treatment of latent tuberculosis infection in individuals at risk.</p> Signup and view all the answers

Describe the diagnostic studies used for tuberculosis and the definitive diagnostic methods.

<p>Diagnostic studies for tuberculosis include sputum cultures, DNA (PCR), and RNA amplification techniques. The definitive diagnostic method involves the identification of Mycobacterium tuberculosis in clinical specimens through culture or molecular testing.</p> Signup and view all the answers

Explain the management considerations for individuals exposed to active tuberculosis and the recommended follow-up guidelines.

<p>Management considerations for individuals exposed to active tuberculosis include screening with the tuberculin skin test (TST), close contact investigation, and initiation of prophylactic treatment in those with a positive TST. Follow-up guidelines involve monitoring for conversion of TST from negative to positive and ensuring completion of the prescribed prophylactic treatment.</p> Signup and view all the answers

Describe the pathophysiology of Mycobacterium tuberculosis infection in the human body.

<p>Mycobacterium tuberculosis enters the body through inhalation and primarily affects the lungs. The bacteria are phagocytosed by alveolar macrophages and can evade host immune responses, leading to the formation of granulomas. Within the granulomas, the bacteria may remain dormant, leading to latent tuberculosis infection, or become active, causing progressive disease.</p> Signup and view all the answers

What are the common risk factors associated with the development of tuberculosis?

<p>Immuno suppression (HIV, cancer, steroids), occupational exposure (health care worker, prison guard), substance abuse (alcohol), diabetes, malnutrition, and poor medical care are common risk factors for tuberculosis.</p> Signup and view all the answers

Describe the pathophysiology of Mycobacterium tuberculosis infection in the human body.

<p>Mycobacterium tuberculosis, with its high lipid content, is an acid-fast bacillus that is inhaled into the lungs and causes infiltration of neutrophils and macrophages. The organism multiplies in macrophages and can move through the lymph system and blood. It typically leads to symptoms such as cough, fever, night sweats, anorexia, and weight loss.</p> Signup and view all the answers

Explain the term 'disease of poverty' in the context of tuberculosis.

<p>Tuberculosis is known as a 'disease of poverty' because of its high prevalence in populations with poor living conditions, malnutrition, and limited access to medical care.</p> Signup and view all the answers

What are the common signs and symptoms of tuberculosis? Describe the PE findings associated with the disease.

<p>Common signs and symptoms of tuberculosis include dry cough, productive cough with or without hemoptysis, fever, chills, drenching night sweats, anorexia, weight loss, and PE findings of chronic illness, malnutrition, lymphadenopathy, hepatosplenomegaly, hypoxia, and cachexia.</p> Signup and view all the answers

Explain the diagnostic studies used for tuberculosis and the definitive diagnostic methods.

<p>Diagnostic studies for tuberculosis include CXR/chest CT, TB skin test, QuantiFERON GOLD blood test, serial sputum smears and cultures, bronchoscopy, and biopsy. The definitive diagnostic methods include acid-fast bacilli detection on sputum gram stain and identification of Mycobacterium tuberculosis.</p> Signup and view all the answers

Explain the treatment regimen for active tuberculosis, including the duration and drugs used.

<p>The treatment regimen for active tuberculosis typically involves a multi-drug approach with isoniazid, rifampin, pyrazinamide, and ethambutol. The duration of treatment is typically 6 months, with an initial 2-month intensive phase followed by a 4-month continuation phase.</p> Signup and view all the answers

What is the primary mode of transmission for tuberculosis?

<p>The primary mode of transmission for tuberculosis is inhaling the organism within aerosol droplets expelled by an individual coughing with active disease.</p> Signup and view all the answers

What percentage of individuals infected with tuberculosis will develop the disease?

<p>10% of individuals infected with tuberculosis will develop the disease.</p> Signup and view all the answers

Explain the significance of caseating granulomas (necrotizing granulomas) in the diagnosis of tuberculosis.

<p>Caseating granulomas are a histologic hallmark of tuberculosis. Their presence in tissue samples, such as lung biopsies, is highly suggestive of tuberculosis infection.</p> Signup and view all the answers

Describe the recommended treatment regimen for active tuberculosis, including the drugs used and the duration of treatment.

<p>The recommended treatment regimen for active tuberculosis involves a minimum of 6 months of treatment using a combination of four drugs: isoniazid, rifampin, ethambutol, and pyrazinamide. The initial phase consists of using all four drugs for 2 months, followed by a continuation phase using isoniazid and rifampin for an additional 4 months.</p> Signup and view all the answers

Explain the management considerations for individuals exposed to active tuberculosis and the recommended follow-up guidelines.

<p>Individuals exposed to active tuberculosis should be screened using the tuberculin skin test (TST). Those with a TST result greater than 5 mm should be treated aggressively. Close contacts, such as children, adolescents, and immunocompromised individuals, should undergo treatment until their TST becomes negative, typically 12 weeks after exposure.</p> Signup and view all the answers

Describe the diagnostic criteria and treatment regimen for multidrug-resistant tuberculosis.

<p>Multidrug-resistant tuberculosis is defined as resistance to both rifampin and isoniazid. The drug regimen for treatment is based on the specific drugs to which the patient is resistant. Prevention emphasizes reducing risk factors and isolating active cases, while treatment involves a drug regimen tailored to the resistance pattern.</p> Signup and view all the answers

Explain the preventive measures for tuberculosis, including primary and secondary prevention strategies.

<p>Primary prevention of tuberculosis involves reducing risk factors and administering the Bacille Calmette-Guérin (BCG) vaccine. Secondary prevention focuses on identifying and isolating active cases, as well as providing appropriate treatment to reduce infectivity.</p> Signup and view all the answers

Describe the radiographic findings in primary tuberculosis and reactivation tuberculosis as seen on chest X-rays.

<p>Primary tuberculosis is characterized by enlargement of the hilar and paratracheal lymph nodes, while reactivation tuberculosis often presents with cavitation and opacities in the upper lung fields, particularly the right upper lobe.</p> Signup and view all the answers

Explain the difference between the treatment regimens for active tuberculosis and latent tuberculosis infection, including the drugs used and the duration of treatment.

<p>The treatment regimen for active tuberculosis involves a combination of four drugs (isoniazid, rifampin, ethambutol, and pyrazinamide) for a minimum of 6 months. In contrast, the treatment for latent tuberculosis infection typically consists of isoniazid daily for 9 months or a combination of isoniazid and rifampin for 3 months.</p> Signup and view all the answers

Explain the term 'disease of poverty' in the context of tuberculosis.

<p>Tuberculosis is often referred to as a 'disease of poverty' because it disproportionately affects socioeconomically disadvantaged populations, where factors such as overcrowding, malnutrition, and limited access to healthcare contribute to the spread and impact of the disease.</p> Signup and view all the answers

Explain the role of T cells and macrophages in the immune response to Mycobacterium tuberculosis infection.

<p>T cells and macrophages surround the organism to form granulomas in response to Mycobacterium tuberculosis infection.</p> Signup and view all the answers

Describe the radiographic findings in extrapulmonary tuberculosis and provide examples of its manifestations.

<p>Extrapulmonary tuberculosis can manifest in the CNS as meningitis, in the lymphatics as scrofula (of the neck), in the pleura as TB pleurisy, and in other areas such as bones &amp; joints, GU, and disseminated miliary TB.</p> Signup and view all the answers

What are the common signs and symptoms of tuberculosis? Describe the PE findings associated with the disease.

<p>Common signs and symptoms of tuberculosis include dry cough, productive cough with or without hemoptysis, fever, chills, drenching night sweats, anorexia, and weight loss. Physical exam findings may include chronically ill and malnourished appearance, lymphadenopathy, hepatosplenomegaly, hypoxia, and cachexia.</p> Signup and view all the answers

Explain the diagnostic studies used for tuberculosis and the definitive diagnostic methods.

<p>Diagnostic studies for tuberculosis include CXR/Chest CT for bilateral patchy infiltrates, TB skin test, QuantiFERON GOLD blood test, serial sputum smears &amp; cultures, bronchoscopy, and biopsy. Definitive diagnosis involves the identification of Mycobacterium tuberculosis through acid-fast bacilli on sputum gram stain.</p> Signup and view all the answers

Explain the pathophysiology of Mycobacterium tuberculosis infection in the human body, focusing on the initial stages of infection.

<p>Mycobacterium tuberculosis, with its high lipid content, is an acid-fast bacilli that is inhaled into the lungs where it lands in areas with increased airflow. This leads to infiltration of neutrophils and macrophages, multiplication of AFB within macrophages, and movement through the lymph system and blood. The immune response is initiated with the formation of granulomas.</p> Signup and view all the answers

Describe the manifestations of extrapulmonary tuberculosis and explain the difference between primary TB and latent TB.

<p>Extrapulmonary tuberculosis can manifest in various sites such as the CNS, lymphatics, pleura, and other areas. Primary TB occurs in individuals who fail to contain the initial infection, leading to active TB, while latent TB occurs in individuals who contain the bacterium without being symptomatic.</p> Signup and view all the answers

Explain the mode of transmission for tuberculosis and the risk factors associated with the development of the disease.

<p>Tuberculosis is transmitted through inhaling organism within aerosol droplets expelled by individuals coughing with active disease. Risk factors include being immunosuppressed (e.g., HIV, cancer, steroids), occupational exposure (e.g., health care workers, prison guards), substance abuse, diabetes, malnutrition, and poor medical care.</p> Signup and view all the answers

Describe the characteristic features of Mycobacterium tuberculosis and the common methods used for its detection.

<p>Mycobacterium tuberculosis has a high lipid content, making it acid-fast on staining. It can be detected through methods such as TB skin test, QuantiFERON GOLD blood test, sputum smears, cultures, bronchoscopy, and biopsy.</p> Signup and view all the answers

TB is often referred to as the ______

<p>disease of poverty</p> Signup and view all the answers

TB is caused by the bacterium Mycobacterium ______

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

Inhalation of droplet nuclei containing Mycobacterium tuberculosis into the lungs is the primary mode of transmission for ______

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

Individuals with latent TB are not symptomatic and are not infectious, but they can develop ______ TB if immunocompromised

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

The formation of granulomas is part of the immune response to Mycobacterium tuberculosis infection, involving T cells and ______

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

A definitive diagnosis of TB involves the identification of acid-fast bacilli on sputum gram stain and ______ detection

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

The presence of drenching night sweats, anorexia, and weight loss are common signs and symptoms of ______

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

Extrapulmonary tuberculosis can manifest in various parts of the body, such as the CNS, lymphatics, pleura, and ______

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

<p>Primary TB is characterized by the enlargement of hilary paratracheal lymph nodes, enlargement of lymph nodes of pulmonary hila, cavitation with progressive disease, segmental atelectasis, and collapse of one or several segments of a lung lobe.</p> Signup and view all the answers

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