Mantoux Tuberculin Skin Test

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.