TB Basics
What does "TB" stand for?
Tuberculosis
How is TB spread?
Respiratory. Through the air from one person to another when an infected person coughs, sneezes, speaks, or sings.
What is the most common symptom of pulmonary (lung) TB?
A persistent cough that lasts for more than 3 weeks.
What is "Directly Observed Therapy" (DOT)?
A healthcare worker or designated individual watches the patient swallow every dose of their TB medication to ensure treatment completion and reduce transmission.
In the 19th and early 20th centuries, what was the common, dreaded nickname for tuberculosis in Canada?
"Consumption" (or sometimes "The White Plague"). It was called consumption because the disease seemed to "consume" or eat away at the body, causing extreme weight loss and fatigue.
TB is a bacteria or virus?
It is caused by the bacterium Mycobacterium tuberculosis
Does everyone exposed to TB develop the disease?
No. Many people who breathe in TB bacteria do not develop the disease, and 90% of those with latent TB never develop active
Besides coughing, what are three "classic" systemic symptoms of active TB?
Night sweats, unintentional weight loss, and fever (often with chills).
How long does treatment for TB disease usually last?
Treatment for TB disease typically lasts 6 to 9 months or longer, using a combination of drugs.
True or False:
Throughout the 20th century, TB rates were the same for Indigenous and non-Indigenous populations in Canada.
False. TB had a devastating impact on First Nations and Inuit populations, particularly in the 1940s-60s, linked to colonial, residential school, and sanatorium systems. Even today, TB rates remain disproportionately higher in these communities.
What is the most common part of the body affected by TB?
The lungs (pulmonary TB), though it can affect other parts of the body.
What type of mask is required for healthcare workers to prevent inhaling TB?
An N95 respirator or higher-level filter (airborne precautions)
What is the medical term for coughing up blood or blood-tinged sputum?
Hemoptysis
How is TB treated?
A. Antiviral medicines
B. Antibiotics
C. Surgery
D. Chemotherapy
Antibiotics
What major medical advancement in the 1950s and 1960s made tuberculosis curable and reduced the need for sanatoria?
The discovery and implementation of antibiotic medications.
Is TB preventable?
Yes, it is preventable proper medical treatment.
Name 3 endemic TB Countries
Which of the following diagnostics tests is intended for latent tuberculosis infection?
a) Sputum smear microscopy
b) Polymerase chain reaction (PCR)
c) Interferon-gamma release assay (lGRA)
d) ELISA for TB antibodies
The correct answer is (c). Interferon-gamma release assays (e.g., TB Gold) are meant for the diagnosis of latent TB infection. They should not be used for active TB diagnosis because they cannot distinguish between latent TB and active disease. A 2011 World Health Organization (WHO) policy discourages their use for active TB diagnosis.
A client is prescribed Rifampin for TB disease. They call LPH panicked because their urine and sweat have turned a bright orange-red color. You should tell the client to:
A) Stop the medication immediately; this is a sign of severe kidney failure.
B) Contact emergency services; the patient is experiencing internal bleeding.
C) Reassure the patient; this is a harmless, known and expected side effect of the drug.
D) Tell them to double their water intake to flush the "toxin" out.
C) Reassure the patient; this is a harmless, known and expected side effect of the drug.
Before the 1950s, where were patients with active tuberculosis in Canada treated to prevent the spread of the disease?
In sanatoria (or sanitariums/TB hospitals). Patients were often isolated in these institutions for months or years, removed from their communities and families.
When is World TB Day?
March 24th of every year
Who is at the highest risk for developing active TB disease after exposure?
People with HIV, individuals recently exposed to someone with active TB, children under the age of 5 years old and those with weakened immune systems (e.g., diabetes, cancer).
Which of the following diagnostics tests can be used to diagnose drug resistant tuberculosis?
a) Sputum smear microscopy
b) Liquid culture
c) Interferon-gamma release assay (IGRA)
d) Chest X-ray
(b). Liquid culture can be used to grow Mycobacterium tuberculosis and also identify drug resistance (to first and second line drugs).
In the standard initial (intensive) phase of TB treatment (the first 2 months), which four medications are typically used together?
A) Isoniazid, Rifampin, Penicillin, and Aspirin
B) Isoniazid, Rifampin, Pyrazinamide, and Ethambutol
C) Amoxicillin, Streptomycin, Ethambutol, and Vitamin C
D) Isoniazid, Moxifloxacin, Rifampin, and Insulin
B) Isoniazid, Rifampin, Pyrazinamide, and Ethambutol
True or False:
Between 1939 and 1944, nearly as many Canadians died of TB (36,000) as died from enemy action (38,000)
True!