Mantoux Tuberculin Skin Test

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Quiz used to test health care providers on their knowledge of TB (Tuberculosis) and the two step Mantoux Test used to test for TB.


Questions and Answers
  • 1. 

    Tuberculosis is caused by a:

    • A.

      Virus

    • B.

      Bacterium

    • C.

      Pox

    • D.

      Parasite

    • E.

      Fungus

    Correct Answer
    B. Bacterium
    Explanation
    Tuberculosis is caused by a bacterium called Mycobacterium tuberculosis. This bacterium primarily affects the lungs but can also affect other parts of the body. It is transmitted through the air when an infected person coughs or sneezes. The bacterium can survive in the body for a long time, leading to the development of active tuberculosis disease. Treatment for tuberculosis involves a combination of antibiotics to kill the bacteria and prevent its spread.

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  • 2. 

    TB infection is spread by:

    • A.

      Contact with blood contaminated with TB bacteria

    • B.

      Contact with clothing contaminated with TB bacteria

    • C.

      Breathing in TB bacteria expelled by a person with infectious TB

    • D.

      Eating with utensils used by a person with infectious TB

    • E.

      All of the above

    Correct Answer
    C. Breathing in TB bacteria expelled by a person with infectious TB
    Explanation
    TB infection is spread through the air when a person with infectious TB coughs or sneezes, releasing bacteria into the air. These bacteria can then be inhaled by others, leading to infection. Contact with blood or clothing contaminated with TB bacteria does not pose a significant risk of transmission, as the bacteria primarily spread through respiratory droplets. Eating with utensils used by a person with infectious TB also does not pose a significant risk, as the bacteria are not typically found in saliva or on utensils. Therefore, the correct answer is breathing in TB bacteria expelled by a person with infectious TB.

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  • 3. 

    What is the most common site for TB disease?

    • A.

      Larynx

    • B.

      Pleura

    • C.

      Lungs

    • D.

      Lymph nodes

    • E.

      Brain

    Correct Answer
    C. Lungs
    Explanation
    The most common site for TB disease is the lungs. Tuberculosis primarily affects the lungs and is caused by the bacteria Mycobacterium tuberculosis. It is an airborne disease that spreads through respiratory droplets when an infected person coughs or sneezes. The bacteria then enters the lungs and can cause symptoms such as coughing, chest pain, and difficulty breathing. TB can also affect other parts of the body, but lung involvement is the most typical and common presentation.

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  • 4. 

    A definitive diagnosis of TB disease is made with a:

    • A.

      Mantoux tuberculin skin test

    • B.

      Chest x-ray

    • C.

      Smear

    • D.

      Culture

    • E.

      Thorough medical history

    Correct Answer
    D. Culture
    Explanation
    A definitive diagnosis of TB disease is made with a culture. This is because a culture test involves growing the bacteria that cause TB in a laboratory setting. This allows for a more accurate identification of the bacteria and confirmation of the disease. Other tests like the Mantoux tuberculin skin test, chest x-ray, smear, and thorough medical history are important in the diagnostic process, but they are not considered definitive for diagnosing TB disease.

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  • 5. 

    Which of the following medical conditions places a person at the highest risk of developing TB disease after becoming infected:

    • A.

      Fatigue

    • B.

      Less than ideal body weight

    • C.

      Pneumonia

    • D.

      HIV infection

    • E.

      Diabetes

    Correct Answer
    D. HIV infection
    Explanation
    HIV infection places a person at the highest risk of developing TB disease after becoming infected. HIV weakens the immune system, making it harder for the body to fight off infections, including tuberculosis. People with HIV are much more likely to progress from latent TB infection to active TB disease compared to those without HIV. This is because their weakened immune system cannot effectively control the TB bacteria, allowing it to multiply and cause disease. Therefore, HIV infection is the medical condition that poses the highest risk for developing TB disease.

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  • 6. 

    The difference between latent TB infection and TB disease is that:

    • A.

      People with latent TB infection are not infectious, whereas people with TB disease are sometimes infectious

    • B.

      Only TB disease can be detected by a tuberculin skin test; latent TB infection cannot

    • C.

      People with latent TB infection are infectious, whereas people with TB disease are not

    • D.

      Latent TB infection is curable but TB disease is not

    Correct Answer
    A. People with latent TB infection are not infectious, whereas people with TB disease are sometimes infectious
    Explanation
    People with latent TB infection have the TB bacteria in their body but do not have any symptoms of the disease and are not infectious. On the other hand, people with TB disease have active symptoms and can spread the bacteria to others through coughing or sneezing. However, it is important to note that not all people with TB disease are always infectious, as it depends on the stage and severity of the disease.

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  • 7. 

    Which of the following is NOT a symptom of active pulmonary TB disease?

    • A.

      Productive, prolonged cough

    • B.

      Fever

    • C.

      Diarrhea

    • D.

      Night sweats

    • E.

      Weight loss

    Correct Answer
    C. Diarrhea
    Explanation
    Diarrhea is not a symptom of active pulmonary TB disease. Active pulmonary TB typically presents with symptoms such as a productive, prolonged cough, fever, night sweats, and weight loss. Diarrhea is not commonly associated with TB and is more commonly seen in other gastrointestinal infections or conditions.

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  • 8. 

    The standard treatment for latent TB infection is to:

    • A.

      Give isoniazid daily for 9 months

    • B.

      Give rifampin and isoniazid daily for 18 months

    • C.

      Closely monitor the patients health status and then give isoniazid only if TB disease develops

    • D.

      Treat with a regimen of 4 drugs for 6 months

    • E.

      Treat with a regimen of 3 drugs for 12 months

    Correct Answer
    A. Give isoniazid daily for 9 months
    Explanation
    The standard treatment for latent TB infection is to give isoniazid daily for 9 months. This is because isoniazid is highly effective in preventing the development of active TB disease in individuals with latent TB infection. It is a first-line medication that targets the TB bacteria and helps to kill it off. The 9-month duration is recommended to ensure that the bacteria are completely eradicated from the body. This treatment regimen has been proven to be effective in reducing the risk of developing active TB disease in individuals with latent infection.

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  • 9. 

    The correct amount of PPD antigen to use in a tuberculin skin test is:

    • A.

      .05 ml of 5 tuberculin units

    • B.

      0.1 ml of 5 tuberculin units

    • C.

      0.5 ml of 5 tuberculin units

    • D.

      1 ml of 5 tuberculin units

    Correct Answer
    B. 0.1 ml of 5 tuberculin units
    Explanation
    The correct amount of PPD antigen to use in a tuberculin skin test is 0.1 ml of 5 tuberculin units. This amount is recommended because it provides an adequate concentration of the antigen for an accurate test result. Using a smaller amount may not provide enough antigen for a reliable reaction, while using a larger amount may increase the risk of false-positive results or adverse reactions. Therefore, 0.1 ml of 5 tuberculin units is the appropriate dosage for a tuberculin skin test.

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  • 10. 

    A Mantoux tuberculin skin test is administered :

    • A.

      Intermuscularly

    • B.

      Intradermally

    • C.

      Subcutaneously

    • D.

      By scratching the skin

    Correct Answer
    B. Intradermally
    Explanation
    A Mantoux tuberculin skin test is administered intradermally. This means that the test is injected into the top layers of the skin, specifically the dermis. This method allows for the accurate measurement of the reaction to the tuberculin, which helps in diagnosing tuberculosis infection. Administering the test intradermally ensures that the tuberculin is delivered to the correct area and allows for easy interpretation of the test results.

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  • 11. 

    A positive skin test means a patient:

    • A.

      Probably has TB disease

    • B.

      Probably has TB infection

    • C.

      Has TB and is infectious

    • D.

      Is allergic to PPD solution

    Correct Answer
    B. Probably has TB infection
    Explanation
    A positive skin test indicates that the patient has been exposed to the bacteria that causes tuberculosis (TB) and has developed an immune response to it. This immune response suggests that the patient has TB infection, meaning that the bacteria is present in their body. However, it does not necessarily mean that the patient has active TB disease. Further tests are needed to determine if the infection has progressed to disease and if the patient is infectious.

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  • 12. 

    A skin test should be read at:

    • A.

      24-48 hours (1 to 2 days)

    • B.

      48 hours (2 days)

    • C.

      48 -72 hours (2 to 3 days)

    • D.

      Anytime up to a week

    Correct Answer
    C. 48 -72 hours (2 to 3 days)
    Explanation
    A skin test should be read at 48-72 hours (2 to 3 days) because this is the optimal time frame for accurately interpreting the results. Reading the test too early or too late may lead to false interpretations and inaccurate diagnosis.

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  • 13. 

    If a client fails to show up for their scheduled reading within 48-72 hours, how long should they wait before scheduling an appointment for retesting? 

    • A.

      7 days

    • B.

      10 days

    • C.

      14 days

    • D.

      No minimum wait is required before repeat testing

    Correct Answer
    D. No minimum wait is required before repeat testing
    Explanation
    If a client fails to show up for their scheduled reading within 48-72 hours, there is no minimum wait required before scheduling an appointment for retesting. This means that the client can immediately schedule another appointment for testing without having to wait for a specific period of time.

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  • 14. 

    When performing the skin test, it is important to record the:

    • A.

      Date

    • B.

      Administrator

    • C.

      Arm of placement

    • D.

      Lot # and expiration date

    • E.

      All of the above

    Correct Answer
    E. All of the above
    Explanation
    When performing a skin test, it is important to record the date, administrator, arm of placement, and lot # and expiration date. This is because these details are crucial for proper documentation and tracking of the test. The date helps in determining the timeline of the test, the administrator helps in identifying who performed the test, the arm of placement helps in identifying the specific location of the test, and the lot # and expiration date help in ensuring that the test is conducted using the correct materials within their validity period.

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  • 15. 

    A tuberculin reaction of 5 mm is positive in:

    • A.

      Persons known to have or suspected of having HIV infection

    • B.

      Close contacts of a person with infectious TB

    • C.

      Persons who have a chest x-ray suggestive of previous TB

    • D.

      All of the above

    Correct Answer
    D. All of the above
    Explanation
    A tuberculin reaction of 5 mm is considered positive in all of the mentioned scenarios. Persons known to have or suspected of having HIV infection, close contacts of a person with infectious TB, and persons who have a chest x-ray suggestive of previous TB are all at higher risk of having tuberculosis. A positive tuberculin reaction indicates exposure to the tuberculosis bacteria and suggests the need for further evaluation and possible treatment to prevent the development of active tuberculosis.

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  • 16. 

    Which patients described below have a positive tuberculin skin test reaction? Check all that apply.

    • A.

      Mr. West, 36 years old with HIV infection, 8 mm induration

    • B.

      Ms. Hernandez, 26 years old, native of mexico, 7 mm induration

    • C.

      Ms. Jones, 56 years old, has diabetes, 12 mm induration

    • D.

      Mr. Sung, 79 years old, resident of a nursing home, 11 mm induration

    Correct Answer(s)
    A. Mr. West, 36 years old with HIV infection, 8 mm induration
    C. Ms. Jones, 56 years old, has diabetes, 12 mm induration
    D. Mr. Sung, 79 years old, resident of a nursing home, 11 mm induration
    Explanation
    A positive tuberculin skin test reaction is indicated by an induration (hardened raised area) at the injection site. In general, an induration of 5 mm or greater is considered positive for individuals with HIV infection, recent close contact with tuberculosis, or chest x-ray findings consistent with previous tuberculosis. Therefore, Mr. West with HIV infection, Ms. Jones with diabetes, and Mr. Sung who is a resident of a nursing home all have positive tuberculin skin test reactions based on their respective induration sizes of 8 mm, 12 mm, and 11 mm. Ms. Hernandez, on the other hand, has an induration size of 7 mm, which is below the threshold for a positive reaction.

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  • 17. 

    How often does the two-step protocol need to be performed?

    • A.

      Once every 6 months

    • B.

      Once a month

    • C.

      Once only, if properly performed and documented

    • D.

      Once every 2 years

    Correct Answer
    C. Once only, if properly performed and documented
    Explanation
    The two-step protocol needs to be performed only once, as long as it is properly performed and documented. This suggests that the protocol is effective in achieving its intended purpose and does not require repetition at regular intervals. The emphasis on proper performance and documentation implies that adherence to the protocol's guidelines is crucial for its effectiveness.

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  • 18. 

    Who should get a two-step skin test?

    • A.

      Health care professionals

    • B.

      Corrections staff

    • C.

      Travelers who are going to an area with a high prevalence of TB for 1 month or more

    • D.

      Residents of Long Term Care facilities

    • E.

      All of the above

    Correct Answer
    E. All of the above
    Explanation
    All of the above should get a two-step skin test. This is because health care professionals, corrections staff, travelers going to high TB prevalence areas for a month or more, and residents of Long Term Care facilities are all at an increased risk of being exposed to tuberculosis. A two-step skin test is a screening tool used to detect the presence of tuberculosis infection in individuals. Therefore, it is recommended for all these groups to undergo this test to ensure early detection and appropriate management if necessary.

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  • 19. 

    Poor adherence to prescribed anti-TB therapy is the most common cause of treatment failure. Directly observed therapy (DOT) is an effective way to monitor adherence to therapy. DOT is defined as:

    • A.

      The process whereby a patient's family member administers medication to the patient

    • B.

      Observing the patient once a week during treatment to ensure he/she is properly taking medications

    • C.

      The process whereby a health care worker or pill dispenser watches the patient swallow each dose of medication

    • D.

      All of the above

    Correct Answer
    C. The process whereby a health care worker or pill dispenser watches the patient swallow each dose of medication
    Explanation
    Poor adherence to prescribed anti-TB therapy is the most common cause of treatment failure. To ensure that patients are properly taking their medications, directly observed therapy (DOT) is implemented. DOT involves a health care worker or pill dispenser watching the patient swallow each dose of medication. This method is effective in monitoring adherence to therapy and reducing the risk of treatment failure.

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  • 20. 

    Why should a two-step TB skin test be performed?

    • A.

      The tuberculin solution may cause the client to become more susceptible to contracting TB infection

    • B.

      A single TST will never cause a response

    • C.

      A single TST may elicit little response yet stimulate an anamnestic immune response, so that a second TST will elicit a much greater response

    • D.

      All of the above

    Correct Answer
    C. A single TST may elicit little response yet stimulate an anamnestic immune response, so that a second TST will elicit a much greater response
    Explanation
    A two-step TB skin test should be performed because a single TST may not elicit a significant response, but it can stimulate an anamnestic immune response. This means that when a second TST is performed, it will elicit a much greater response. This is important because it helps to accurately identify individuals who have been previously exposed to TB and have developed an immune response. By performing a two-step test, healthcare professionals can more accurately diagnose TB infection and determine the appropriate course of treatment.

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  • 21. 

    When patients who initially have drug susceptible TB bacteria later become drug-resistant as a result of inadequate or irregular treatment because of non adherence in drug taking, this is known as:

    • A.

      Primary drug resistance

    • B.

      Acquired drug resistance

    • C.

      Initial drug resistance

    • D.

      None of the above

    Correct Answer
    B. Acquired drug resistance
    Explanation
    Acquired drug resistance refers to the development of drug-resistant TB bacteria in patients who were initially drug susceptible but became resistant due to inadequate or irregular treatment. This occurs when patients do not adhere to the prescribed drug regimen, allowing the bacteria to adapt and become resistant to the drugs. Primary drug resistance, on the other hand, refers to the presence of drug-resistant TB bacteria in patients who have never been treated for TB before. Therefore, the correct answer is acquired drug resistance.

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  • 22. 

    Most children with 'TB Disease' are asymptomatic at presentation. This is especially true of children under 5 years of age.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    Most children with TB Disease do not show any symptoms when they are initially diagnosed. This is particularly common in children who are under 5 years old. Therefore, the statement that most children with TB Disease are asymptomatic at presentation is true.

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  • 23. 

    Tuberculosis is solely a respiratory infection. It never travels to other parts of the body.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    The statement that tuberculosis is solely a respiratory infection and never travels to other parts of the body is false. Tuberculosis is caused by the bacteria Mycobacterium tuberculosis, which primarily affects the lungs but can also spread to other organs and tissues through the bloodstream. This can lead to extrapulmonary tuberculosis, where the infection can affect areas such as the lymph nodes, bones, joints, kidneys, and even the brain. Therefore, tuberculosis can indeed travel to other parts of the body.

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  • 24. 

    Since 1991, there has been a global consensus known as the "DOTS Strategy", led by the WHO, on what constitutes good practice in public health programs for TB.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    The statement is true because since 1991, there has indeed been a global consensus known as the "DOTS Strategy" led by the World Health Organization (WHO) on what constitutes good practice in public health programs for tuberculosis (TB). This strategy focuses on five key components: government commitment, case detection through quality-assured bacteriology, standardized treatment with direct observation, an uninterrupted supply of quality drugs, and a standardized recording and reporting system. The DOTS Strategy has been widely adopted and has played a crucial role in the global efforts to control and eliminate TB.

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  • 25. 

    It is essential from the onset of a TB outbreak that there be adequate staffing and resources for investigation and management.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    The statement emphasizes the importance of having sufficient staffing and resources during the early stages of a TB outbreak for effective investigation and management. This is because timely detection, containment, and treatment of TB cases are crucial in preventing the spread of the disease and minimizing its impact on public health. Inadequate staffing and resources can lead to delays in identifying and isolating infected individuals, resulting in further transmission and increased burden on healthcare systems. Therefore, it is crucial to ensure adequate support from the beginning of a TB outbreak.

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  • 26. 

    Persons with HIV infection & LTBI have an extremely low risk of progression to active TB disease.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Persons with HIV infection have a weakened immune system, making them more susceptible to developing active tuberculosis (TB) disease. Additionally, individuals with latent tuberculosis infection (LTBI) are at risk of progressing to active TB disease if their immune system becomes compromised. Therefore, the statement that persons with HIV infection and LTBI have an extremely low risk of progression to active TB disease is false.

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  • 27. 

    A chest x-ray is used to detect Primary TB Disease and a TB skin test is used to detect Latent TB infection.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    A chest x-ray is a diagnostic tool that can detect active tuberculosis (TB) disease in the lungs, which is known as primary TB disease. It can show any abnormalities or signs of infection in the lungs caused by TB bacteria. On the other hand, a TB skin test, also known as a Mantoux test, is used to detect latent TB infection. This means that the person has been infected with TB bacteria but does not have active TB disease. The skin test determines if a person has been exposed to TB bacteria by measuring the immune response to the bacteria. Therefore, the statement is true.

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  • 28. 

    TB incidence rate in many First Nations and Inuit populations is significantly higher than in non-Aboriginal Canadian-born population.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    The statement is true because there is evidence to support the fact that the incidence rate of tuberculosis (TB) is higher in First Nations and Inuit populations compared to non-Aboriginal Canadian-born population. This disparity can be attributed to various factors such as overcrowded housing, limited access to healthcare, and social determinants of health. These populations often face higher rates of poverty and have a higher prevalence of risk factors for TB, leading to a higher incidence rate.

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  • 29. 

    The cultural, social and linguistic diversity of new major risk groups does not pose challenges for programs designed from a domestic control perspective.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    The cultural, social, and linguistic diversity of new major risk groups does pose challenges for programs designed from a domestic control perspective. This is because these programs may not adequately address the specific needs and contexts of these diverse groups, leading to ineffective interventions and limited success in risk prevention and control. It is important for programs to be culturally sensitive, inclusive, and tailored to the unique characteristics and challenges of each risk group in order to effectively address their needs and mitigate risks.

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  • 30. 

    Bacillus Calmette-Guerin (BCG) vaccination is a very controversial subject, because the efficacy of BCG vaccination has varied from zero to more than 80%.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    The statement is true because the efficacy of BCG vaccination has indeed varied from zero to more than 80%. This means that in some cases, the BCG vaccine has been found to have no effect in preventing tuberculosis, while in other cases it has shown to be effective in reducing the risk of developing the disease by more than 80%. This controversy arises from the fact that the effectiveness of the BCG vaccine can vary depending on various factors such as the strain of the bacteria, the age of the individual receiving the vaccine, and the prevalence of tuberculosis in the population.

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  • Current Version
  • Mar 22, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Jul 12, 2010
    Quiz Created by
    Sunshine1
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