NURS 3370 PHARMACOLOGY MODULE 2 EXAM QUESTIONS
AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
How many people are infected worldwide with TB?
about 2 billion worldwide
How many people are killed per year with TB?
about 1.3 million
Are cases of TB declining or increasing in the US?
declining
Are cases of TB declining or increasing outside of the US?
increasing
Pathogenesis of TB?
Mycobacterium tuberculosis/ tubercle bacillus
Is TB limited to the lungs?
no, may spread through cardiovascular or lymphatic system (macrophages and
neutrophils)
Are there any obvious symptoms of TB?
No
How many people harbor tubercle bacilli but show NO symptoms?
about 10 million people
How does one come to a definitive diagnosis of TB? (2 tests)
,- chest x-ray
-sputum culture
Primary infection routes of latent TB..
- person to person
-inhalation of infected, aerosolized sputum through coughing or sneezing
What percent of people with normal immune systems never develop clinical or x-
ray evidence of TB?
90%
TB develops when...
the immune system fails to control primary infection
TB causes ... and ...
-necrosis and cavitation of lung tissue
-severe destruction without treatment
Reactivation of TB is the
renewal of dormant tubercle bacilli (unless drugs given)
Reactivation of TB causes what percent of new infections
60%
Is hospitalization necessary with more effective drugs treating TB?
no
When treating active TB we should always treat with ____ or more drugs
2
____ observation of drug administration with TB is considered standard care
direct
,When is treatment for TB considered effective?
when no mycobacteria are observed in sputum and no colonies are present in culture
TST
tuberculin skin test
IGRA
Interferon-gamma release assay (test for TB)
Infection with resistant TB results from (2 ways)
-contact with a person who harbors resistant bacteria
-repeated ineffectual courses of therapy
3 causes of drug resistance with TB
-Some infecting bacilli are inherently resistant
-Some develop resistance during treatment
-Resistance to one drug versus many drugs
Multidrug-resistant TB (MDR-TB) is resistant to both..
isoniazid and rifampin
Extensively drug-resistant TB (XDR TB) is resistant to
-Isoniazid (INH)
-Rifampin
-All fluoroquinolones
-at least one of the injectable second-line drugs
Can infection with multidrug-resistant organisms increase risk for death?
greatly
Treatment regimens for TB should start with determining...
, drug sensitivity
What are the two phases of treatment regimen for TB?
-Induction phase: eliminate actively dividing bacilli
-Continuation phase: eliminate intracellular "persisters" to avoid developing a new
resistant strain
Why are patients with TB and HIV infections a special challenge?
In the individual host the two pathogens, M. tuberculosis and HIV, potentiate one
another, accelerating the deterioration of immunological functions and resulting
in premature death if untreated.
Duration of treatment of drug sensitive TB, MDR TB, HIV/AIDS with TB
-min. 6 months for drug sensitive TB
-Up to 24 months for MDR TB or HIV/AIDS
What is DOT? What disease is it preferred for core management strategy for all
patients?
Direct observation therapy
for pts. taking TB meds
What is the most common cause of treatment failure, relapse, and increased drug
resistance in TB?
patient nonadherence
What does DOT allow for?
ongoing assessment of clinical signs
What are the three modes of evaluating therapy in TB?
AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
How many people are infected worldwide with TB?
about 2 billion worldwide
How many people are killed per year with TB?
about 1.3 million
Are cases of TB declining or increasing in the US?
declining
Are cases of TB declining or increasing outside of the US?
increasing
Pathogenesis of TB?
Mycobacterium tuberculosis/ tubercle bacillus
Is TB limited to the lungs?
no, may spread through cardiovascular or lymphatic system (macrophages and
neutrophils)
Are there any obvious symptoms of TB?
No
How many people harbor tubercle bacilli but show NO symptoms?
about 10 million people
How does one come to a definitive diagnosis of TB? (2 tests)
,- chest x-ray
-sputum culture
Primary infection routes of latent TB..
- person to person
-inhalation of infected, aerosolized sputum through coughing or sneezing
What percent of people with normal immune systems never develop clinical or x-
ray evidence of TB?
90%
TB develops when...
the immune system fails to control primary infection
TB causes ... and ...
-necrosis and cavitation of lung tissue
-severe destruction without treatment
Reactivation of TB is the
renewal of dormant tubercle bacilli (unless drugs given)
Reactivation of TB causes what percent of new infections
60%
Is hospitalization necessary with more effective drugs treating TB?
no
When treating active TB we should always treat with ____ or more drugs
2
____ observation of drug administration with TB is considered standard care
direct
,When is treatment for TB considered effective?
when no mycobacteria are observed in sputum and no colonies are present in culture
TST
tuberculin skin test
IGRA
Interferon-gamma release assay (test for TB)
Infection with resistant TB results from (2 ways)
-contact with a person who harbors resistant bacteria
-repeated ineffectual courses of therapy
3 causes of drug resistance with TB
-Some infecting bacilli are inherently resistant
-Some develop resistance during treatment
-Resistance to one drug versus many drugs
Multidrug-resistant TB (MDR-TB) is resistant to both..
isoniazid and rifampin
Extensively drug-resistant TB (XDR TB) is resistant to
-Isoniazid (INH)
-Rifampin
-All fluoroquinolones
-at least one of the injectable second-line drugs
Can infection with multidrug-resistant organisms increase risk for death?
greatly
Treatment regimens for TB should start with determining...
, drug sensitivity
What are the two phases of treatment regimen for TB?
-Induction phase: eliminate actively dividing bacilli
-Continuation phase: eliminate intracellular "persisters" to avoid developing a new
resistant strain
Why are patients with TB and HIV infections a special challenge?
In the individual host the two pathogens, M. tuberculosis and HIV, potentiate one
another, accelerating the deterioration of immunological functions and resulting
in premature death if untreated.
Duration of treatment of drug sensitive TB, MDR TB, HIV/AIDS with TB
-min. 6 months for drug sensitive TB
-Up to 24 months for MDR TB or HIV/AIDS
What is DOT? What disease is it preferred for core management strategy for all
patients?
Direct observation therapy
for pts. taking TB meds
What is the most common cause of treatment failure, relapse, and increased drug
resistance in TB?
patient nonadherence
What does DOT allow for?
ongoing assessment of clinical signs
What are the three modes of evaluating therapy in TB?
