Tuberculosis

~ Exam ~

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1. Robert Koch is responsible for:

  a. Discovering streptomycin

  b. Isolating M. tuberculosis

  c. Demonstrating TB is an infectious disease

  d. Attenuating M. bovis for the BCG vaccine


2. The primary mode of M. tuberculosis transmission is:

  a. Inhalation of infected droplet nuclei

  b. Drinking of non-pasteurized dairy products

  c. Aerosol-producing procedures in an unventilated room

  d. Contact with contaminated surfaces or objects


3. An infected individual is at greatest risk of developing TB disease:

  a. Within the first 2-10 weeks after infection

  b. In the first 1-2 years after infection

  c. Between 20 and 25 years after infection

  d. Risk is the same throughout a person's lifetime


4. The greatest risk factor in the progression of TB infection to TB disease is:

  a. HIV infection

  b. Diabetes Mellitus

  c. Repeated contact with contaminated objects

  d. Immunosuppressive therapy


5. Which of the following statements is true regarding TB infection and TB disease:

  a. Infection always leads to disease at some point

  b. Individuals who are infected develop blotchy skin, and suffer night blindness

  c. If infected, sputum cultures are positive for TB

  d. Infected individuals have the bacteria present in his or her body and may develop TB in their lifetime


6. Mantoux skin tests are read by:

  a. Measuring redness at injection site

  b. Measuring induration at injection site

  c. Measuring skin discoloration of any kind

  d. By individuals at home using a ruler


7. After a person has become infected with TB disease, how long before a Mantoux skin test can detect an immune response:

  a. 1-2 years

  b. Immediately

  c. 2 weeks to 10 weeks

  d. Not until a positive chest radiograph or sputum culture


8. The definitive procedure used for diagnosing pulmonary TB disease is:

  a. Mantoux skin test

  b. Lung volume test

  c. Blood test

  d. Sputum culture


9. The primary preventive anti-tuberculosis drug is:

  a. Streptomycin

  b. Isoniazid (INH)

  c. Rifampin

  d. Penicillin


10. Nonadherence to TB treatment leads to:

  a. Relapse, continued transmission and development of drug resistance

  b. HIV infection

  c. Insomnia and blotchy skin

  d. Outbursts of violent behavior


11. Drug resistance usually results from:

  a. Excessive liver damage

  b. Successful completion of TB therapy

  c. Pregnancy

  d. Inadequate prior treatment of TB


12. The risk of TB infection is the same for HIV-infected individuals as non HIV-infected individuals.

  a. True

  b. False


13. A factor related to the increase in TB cases between 1984-1993 is:

  a. Emergence of managed care

  b. HIV/AIDS epidemic

  c. Less restrictive isolation policies

  d. Decreased availability of anti-tuberculosis drugs


14. In the US, approximately how many individuals are infected with TB?

  a. Only foreign born individuals

  b. Less than 10 thousand

  c. 250 million

  d. 10 to 15 million


15. The risk of transmission in dental settings is considered to be:

  a. Minimal

  b. Very low

  c. Low

  d. Intermediate


16. The foundation of a TB control policy in the dental office is:

  a. Treating many individuals with TB Disease

  b. Taking a TB Control course annually

  c. Refusing dental treatment

  d. Conducting a TB Risk Assessment


17. The CDC recommends yearly skin testing of dental workers in dental settings with __________ designation:

  a. Low risk

  b. Minimal risk

  c. Very low risk

  d. None of the above


18. Which of the following patients has a positive skin test reaction (Refer to Appendix A ):

  a. Ms. Gonzales, 25 years old, native of Mexico, 7 mm of induration

  b. Mr. Jones, 20 years old, no risk factors, 14 mm of induration

  c. Ms. Smith, 37 years old, HIV-infected, 8 mm of induration

  d. All of the above


19. Mr. Wu emigrated from Mainland China. He is given a TB skin test and the result is 17 mm of induration. He says he was vaccinated against TB as a child. He also says his wife was treated for pulmonary TB disease last year. From this scenario you surmise:

  a. His wife is likely to die of the disease

  b. He's not telling the truth, because there is no vaccine for TB

  c. This could be a false-positive reaction due to the vaccination

  d. He is HIV positive


20. If a patient states he or she is PPD positive you should:

  a. Isolate the patient because they are infectious

  b. Ask them to wear a surgical mask, gloves and gown

  c. Ask when they were tested and if they are receiving preventive treatment for TB

  d. None of the above


21. A major side effect of anti-tuberculosis drugs is hepatitis.

  a. True

  b. Fasle


22. Topical antifungals negatively interact with Rifampin.

  a. True

  b. False


23. You call the health department and find out there were six cases of TB in your community last year. You do not treat active TB cases in your practice setting and have referred anyone suspected of having active TB to a collaborating facility. Your dental setting risk category is considered to be:

  a. Low

  b. Very low

  c. High

  d. Intermediate


24. The anti-tuberculosis drug that causes some body fluids (urine, sweat, saliva or tears) to become orange-red in color is:

  a. INH

  b. Rifampin

  c. Ethambutol

  d. Pyrazinamide


25. Dr. Gordon had a Mantoux skin test her senior year in dental school and the result was negative. She was recently tested again and the result (based on her risk factors) was deemed positive. She is considered to be:

  a. HIV Positive

  b. A TB case

  c. A PPD converter

  d. Allergic to INH