Epidemiology
Mr Flanagan spent many years working in rural Africa on the Makhatini Flats of Kwazulu, bordering Mozambique.
Which country are the Makhatini Flats located in?
A. Lesotho
B. South Africa
C. Zimbabwe
D. Malawi
South Africa
Which of the following is NOT a recognised factor for developing active TB?
A. HIV infection
B. Crowded living conditions
C. Diabetes mellitus
D. Regular exercise
Regular exercise
What is the primary site of infection in TB?
A. Alveoli
B. Lymph nodes
C. Liver
D. Kidneys
Alveoli
What are the signs and symptoms of latent TB?
Latent TB is asymptomatic.
What is the gold standard for confirming a tuberculosis diagnosis?
A. Sputum smear microscopy
B. Tuberculin skin test (TST)
C. Interferon-gamma release assay (IGRA)
D. Culture of Mycobacterium tuberculosis
Culture of Mycobacterium tuberculosis
Which region has the highest burden of TB globally?
A. North America
B. Sub-Saharan Africa
C. Western Europe
D. Southeast Asia
Southeast Asia
(Number of new TB cases in 2023 (WHO): SE Asia 45%, Africa 24%, Western Pacific 17%)
Why are individuals with HIV at higher risk for developing active TB?
A. HIV increases drug resistance
B. HIV destroys CD4+ T cells, weakening immune system defenses
C. HIV is a reservoir for Mycobacterium tuberculosis
D. HIV directly causes pulmonary damage
HIV destroys CD4+ T cells, weakening immune system defenses
What forms the central structure of a granuloma in TB?
A. Neutrophils and bacteria
B. Fibroblasts and lymphocytes
C. Caseous necrosis surrounded by macrophages
D. Scar tissue
Caseous necrosis surrounded by macrophages
Night sweats, weight loss, and fever in a patient with a chronic cough are classic signs of:
A. Pneumonia
B. Tuberculosis
C. Asthma
D. Chronic obstructive pulmonary disease (COPD)
Tuberculosis
Chest X-rays are beneficial for finding TB characteristics such as lymph node enlargement, consolidations in lung tissue, and pleural effusion. What is the main limitation of chest X-rays when trying to diagnose if a patient has TB?
Can only test for active TB.
What is the estimated proportion of the global population infected with Mycobacterium tuberculosis (latent or active)?
A. 5%
B. 10%
C. 25%
D. 50%
25% (estimate from WHO and NIH as of 2017 https://doi.org/10.14745/ccdr.v43i34a01)
I DO NOT CONDONE THIS...
But if you kissed someone with active TB would you be at risk of developing TB yourself?
No, TB is spread via air droplets/airborne.
What is the name for the primary lesion of the lungs that progresses to a caseating ("cheese-like appearance") granuloma formation with hilar lymph node involvement?
A. Ghon focus
B. Ghon complex
C. Ranke complex
D. "What do you call a dinosaur made of cheese?"
Ghon complex
Gorgonzilla!
In the Tuberculin skin test (TST), how big does the induration (raised area), as a reaction to the injection, have to be to give a positive result?
>= 5mm
or
>=10mm