| What is considered unexplained documented weight loss in the last 3 months? | ≥ 5% in last 3 months | Unexplained docu- mented weight loss of ≥ 5% in last 3 months • Temperature, Weight, Mid Arm Circumference (MAC), Lymphadenopathy, cold abscess, discharging sinus • Chest examination findings depend upon underlying pathology like consolidation, pleural effusion etc. Unremitting cough for | 40 | definition | 1.000 | Unexplained docu- mented weight loss of ≥ 5% in last 3 months • Temperature, Weight, Mid Arm Circumference (MAC), Lymphadenopathy, cold abscess, discharging sinus • Chest examination findings depend upon underlying pathology like consolidation, pleural effusion etc. | 1 | page=1,block=0 | 0.700 | valid |
| What is the meaning of the abbreviation FL-LPA? | First line - Line probe assay | Km, Cm, Lzd) **LPA may be done directly if smear +ve else send for MGIT followed by FLPA to evaluate for H (inhA and/ or KatG mutn) and Eto (inhA) resistance ADA: Adenosine Deaminase BAL: Broncho-alveolar lavage CBNAAT: Cartidge-based Nucleic Acid Amplification test CECT: Contrast enhanced CT CP: Continuation phase CT: Computed tomography DRTB: Drug resistant TB DST: Drug sensitivity test EPTB: Extra-pulmonary TB ETO: Ethionamide FDC: Fixed dose combination FL-LPA: First line - Line probe assay FQ: Fluoroquinolones GA: Gastric aspirate H: Isoniazid HIV: Human Immunodeficiency virus HRZE: Isoniazid; Rifampicin; Pyrazinamide; Ethambutol IGRA: Interferon Gamma Release assay IS: Induced sputum LN: Lymph node MAC: Mid Arm Circumference MTB: Mycobacterium Tuberculosis NAAT: Nucleic acid amplification test PPD: Purified Protein Derivative RIF: Rifampicin SAM: Severe acute malnutrition SLI: Second line injectables SL-LPA: Second line - Line probe assay TST: Tuberculin skin test USG: Ultrasonography ZN: Ziehl Neelson | 470 | definition | 1.000 | Km, Cm, Lzd) **LPA may be done directly if smear +ve else send for MGIT followed by FLPA to evaluate for H (inhA and/ or KatG mutn) and Eto (inhA) resistance ADA: Adenosine Deaminase BAL: Broncho-alveolar lavage CBNAAT: Cartidge-based Nucleic Acid Amplification test CECT: Contrast enhanced CT CP: Continuation phase CT: Computed tomography DRTB: Drug resistant TB DST: Drug sensitivity test EPTB: Extra-pulmonary TB ETO: Ethionamide FDC: Fixed dose combination FL-LPA: First line - Line probe assay FQ: Fluoroquinolones GA: Gastric aspirate H: Isoniazid HIV: Human Immunodeficiency virus HRZE: |
| What is the full form of CBNAAT? | Cartidge-based Nucleic Acid Amplification test | Km, Cm, Lzd) **LPA may be done directly if smear +ve else send for MGIT followed by FLPA to evaluate for H (inhA and/ or KatG mutn) and Eto (inhA) resistance ADA: Adenosine Deaminase BAL: Broncho-alveolar lavage CBNAAT: Cartidge-based Nucleic Acid Amplification test CECT: Contrast enhanced CT CP: Continuation phase CT: Computed tomography DRTB: Drug resistant TB DST: Drug sensitivity test EPTB: Extra-pulmonary TB ETO: Ethionamide FDC: Fixed dose combination FL-LPA: First line - Line probe assay FQ: Fluoroquinolones GA: Gastric aspirate H: Isoniazid HIV: Human Immunodeficiency virus HRZE: Isoniazid; Rifampicin; Pyrazinamide; Ethambutol IGRA: Interferon Gamma Release assay IS: Induced sputum LN: Lymph node MAC: Mid Arm Circumference MTB: Mycobacterium Tuberculosis NAAT: Nucleic acid amplification test PPD: Purified Protein Derivative RIF: Rifampicin SAM: Severe acute malnutrition SLI: Second line injectables SL-LPA: Second line - Line probe assay TST: Tuberculin skin test USG: Ultrasonography ZN: Ziehl Neelson | 220 | definition | 0.980 | Km, Cm, Lzd) **LPA may be done directly if smear +ve else send for MGIT followed by FLPA to evaluate for H (inhA and/ or KatG mutn) and Eto (inhA) resistance ADA: Adenosine Deaminase BAL: Broncho-alveolar lavage CBNAAT: Cartidge-based Nucleic Acid Amplification test CECT: Contrast enhanced CT CP: Continuation phase CT: Computed tomography DRTB: Drug resistant TB DST: Drug sensitivity test EPTB: Extra-pulmonary TB ETO: Ethionamide FDC: Fixed dose combination FL-LPA: First line - Line probe assay FQ: Fluoroquinolones GA: Gastric aspirate H: Isoniazid HIV: Human Immunodeficiency virus HRZE: |
| What is the expanded form of FL-LPA? | First line - Line probe assay | Km, Cm, Lzd) **LPA may be done directly if smear +ve else send for MGIT followed by FLPA to evaluate for H (inhA and/ or KatG mutn) and Eto (inhA) resistance ADA: Adenosine Deaminase BAL: Broncho-alveolar lavage CBNAAT: Cartidge-based Nucleic Acid Amplification test CECT: Contrast enhanced CT CP: Continuation phase CT: Computed tomography DRTB: Drug resistant TB DST: Drug sensitivity test EPTB: Extra-pulmonary TB ETO: Ethionamide FDC: Fixed dose combination FL-LPA: First line - Line probe assay FQ: Fluoroquinolones GA: Gastric aspirate H: Isoniazid HIV: Human Immunodeficiency virus HRZE: Isoniazid; Rifampicin; Pyrazinamide; Ethambutol IGRA: Interferon Gamma Release assay IS: Induced sputum LN: Lymph node MAC: Mid Arm Circumference MTB: Mycobacterium Tuberculosis NAAT: Nucleic acid amplification test PPD: Purified Protein Derivative RIF: Rifampicin SAM: Severe acute malnutrition SLI: Second line injectables SL-LPA: Second line - Line probe assay TST: Tuberculin skin test USG: Ultrasonography ZN: Ziehl Neelson | 470 | definition | 0.980 | Km, Cm, Lzd) **LPA may be done directly if smear +ve else send for MGIT followed by FLPA to evaluate for H (inhA and/ or KatG mutn) and Eto (inhA) resistance ADA: Adenosine Deaminase BAL: Broncho-alveolar lavage CBNAAT: Cartidge-based Nucleic Acid Amplification test CECT: Contrast enhanced CT CP: Continuation phase CT: Computed tomography DRTB: Drug resistant TB DST: Drug sensitivity test EPTB: Extra-pulmonary TB ETO: Ethionamide FDC: Fixed dose combination FL-LPA: First line - Line probe assay FQ: Fluoroquinolones GA: Gastric aspirate H: Isoniazid HIV: Human Immunodeficiency virus HRZE: |
| What does CBNAAT refer to? | Cartidge-based Nucleic Acid Amplification test | Km, Cm, Lzd) **LPA may be done directly if smear +ve else send for MGIT followed by FLPA to evaluate for H (inhA and/ or KatG mutn) and Eto (inhA) resistance ADA: Adenosine Deaminase BAL: Broncho-alveolar lavage CBNAAT: Cartidge-based Nucleic Acid Amplification test CECT: Contrast enhanced CT CP: Continuation phase CT: Computed tomography DRTB: Drug resistant TB DST: Drug sensitivity test EPTB: Extra-pulmonary TB ETO: Ethionamide FDC: Fixed dose combination FL-LPA: First line - Line probe assay FQ: Fluoroquinolones GA: Gastric aspirate H: Isoniazid HIV: Human Immunodeficiency virus HRZE: Isoniazid; Rifampicin; Pyrazinamide; Ethambutol IGRA: Interferon Gamma Release assay IS: Induced sputum LN: Lymph node MAC: Mid Arm Circumference MTB: Mycobacterium Tuberculosis NAAT: Nucleic acid amplification test PPD: Purified Protein Derivative RIF: Rifampicin SAM: Severe acute malnutrition SLI: Second line injectables SL-LPA: Second line - Line probe assay TST: Tuberculin skin test USG: Ultrasonography ZN: Ziehl Neelson | 220 | definition | 0.980 | Km, Cm, Lzd) **LPA may be done directly if smear +ve else send for MGIT followed by FLPA to evaluate for H (inhA and/ or KatG mutn) and Eto (inhA) resistance ADA: Adenosine Deaminase BAL: Broncho-alveolar lavage CBNAAT: Cartidge-based Nucleic Acid Amplification test CECT: Contrast enhanced CT CP: Continuation phase CT: Computed tomography DRTB: Drug resistant TB DST: Drug sensitivity test EPTB: Extra-pulmonary TB ETO: Ethionamide FDC: Fixed dose combination FL-LPA: First line - Line probe assay FQ: Fluoroquinolones GA: Gastric aspirate H: Isoniazid HIV: Human Immunodeficiency virus HRZE: |
| What determines the findings of a chest examination? | underlying pathology like consolidation, pleural effusion etc. | Unexplained docu- mented weight loss of ≥ 5% in last 3 months • Temperature, Weight, Mid Arm Circumference (MAC), Lymphadenopathy, cold abscess, discharging sinus • Chest examination findings depend upon underlying pathology like consolidation, pleural effusion etc. Unremitting cough for | 204 | relationship | 0.970 | Unexplained docu- mented weight loss of ≥ 5% in last 3 months • Temperature, Weight, Mid Arm Circumference (MAC), Lymphadenopathy, cold abscess, discharging sinus • Chest examination findings depend upon underlying pathology like consolidation, pleural effusion etc. Unremitting cough for | 1 | page=1,block=0 | 0.700 | valid |
| What needs to be assessed within two weeks of starting tuberculosis treatment? | checking that- correct dose, combination of drugs is being taken, adherence and tolerance to drugs | Intensive phase • Consider steroids in miliary TB with hypoxia, Endobronchial TB massive bilateral effusion with distress • Prednisone dose 2 mg/kg daily or Dexamethasone 0.6 mg/kg/day for 4 weeks • Reduce dose gradually over next 4 weeks before stopping • Pyridoxine 10 mg/day for 6 months • Nutritional support • Treat co-morbid conditions: HIV, SAM ABBREVIATIONS MONITORING When to assess • Within 2 weeks of starting therapy for checking that- correct dose, combination of drugs is being taken, adherence and tolerance to drugs • Then every month till completion of treatment What to assess • Appropriateness of therapy: • Correct combination, acceptance/tolerance • Counsel about need to complete & not miss on doses (Inform, if doses are missed) • Response to therapy: • Clinical (symptoms, adverse effects, weight, dose revision) • X-ray at end of therapy • Do X-ray for worsening at any time OR slow resolution OR persistent symptoms at end of IP • NAAT is not appropriate follow up tool for monitoring progress of disease • Smear examination at end of treatment (to declare outcome) • Repeat microbiological test (smear, MGIT, NAAT) at end of IP & at end of therapy, if still symptomatic or any deterioration/failure to respond • After treatment completion: follow up patients clinically at end of 6, 12, 18 & 24 months *A=Adult FDC (HRZE = 75/150/400/275; HRE = 75/150/275) |
| What should be done in case of nonresponse in the context of Rif resistance? | Reinvestigate for nonresponse including for DRTB | Rif resistance -ve Rif resistance +ve$ Repeat NAAT FL-LPA SL - LPA* Reinvestigate for nonresponse including for DRTB Rif resistance -ve H Resistant (inhA and/or KatG mutation) Eto resistance (inhA mutation) FQ and/or SLI Resistance | 68 | summary | 0.970 | Rif resistance -ve Rif resistance +ve$ Repeat NAAT FL-LPA SL - LPA* Reinvestigate for nonresponse including for DRTB Rif resistance -ve H Resistant (inhA and/or KatG mutation) Eto resistance (inhA mutation) FQ and/or SLI Resistance | 1 | page=1,block=66 | 0.700 | valid |
| What should be done if interruption of treatment occurs for up to 4 weeks? | Resume therapy (Restart if missed within 1st 4 weeks) | Interruption up to 4 weeks Resume therapy (Restart if missed within 1st 4 weeks) Reinvestigate for DRTB Rif resistance not detected Rif resistance detected Treat as MDRTB Retreat with 1st line drugs and Check for INH resistance and treat • In case interruption happens in CP & on retrieval, the patient has no clinical evidence of active disease & tests for DRTB are negative, the remaining treatment course to be completed • Resons for interruption should always be evaluated & addressed in all cases (Address myths/fear or any intolerance) Interruption over 4 weeks Fibrocavitary shadows Suggestive of TB Miliary Shadows Suggestive of TB Hilar LN enlargement Suggestive of TB Paratracheal LN Suggestive of TB Pleural Effusion Pleural fluid for NAAT, cytology, biochemistry & Sputum/GA/IS for NAAT for MTB Microbiologically confirmed TB case Straw colored, exudative effusion MTB -ve MTB +ve MTB -ve | 27 | summary | 0.970 | Interruption up to 4 weeks Resume therapy (Restart if missed within 1st 4 weeks) Reinvestigate for DRTB Rif resistance not detected Rif resistance detected Treat as MDRTB Retreat with 1st line drugs and Check for INH resistance and treat • In case interruption happens in CP & on retrieval, the patient has no clinical evidence of active disease & tests for DRTB are negative, the remaining treatment course to be completed • Resons for interruption should always be evaluated & addressed in all cases (Address myths/fear or any intolerance) Interruption over 4 weeks Fibrocavitary shadows |
| What should be done if a tuberculosis treatment interruption lasts up to four weeks? | Resume therapy (Restart if missed within 1st 4 weeks) | Interruption up to 4 weeks Resume therapy (Restart if missed within 1st 4 weeks) Reinvestigate for DRTB Rif resistance not detected Rif resistance detected Treat as MDRTB Retreat with 1st line drugs and Check for INH resistance and treat • In case interruption happens in CP & on retrieval, the patient has no clinical evidence of active disease & tests for DRTB are negative, the remaining treatment course to be completed • Resons for interruption should always be evaluated & addressed in all cases (Address myths/fear or any intolerance) Interruption over 4 weeks Fibrocavitary shadows Suggestive of TB Miliary Shadows Suggestive of TB Hilar LN enlargement Suggestive of TB Paratracheal LN Suggestive of TB Pleural Effusion Pleural fluid for NAAT, cytology, biochemistry & Sputum/GA/IS for NAAT for MTB Microbiologically confirmed TB case Straw colored, exudative effusion MTB -ve MTB +ve MTB -ve | 27 | summary | 0.970 | Interruption up to 4 weeks Resume therapy (Restart if missed within 1st 4 weeks) Reinvestigate for DRTB Rif resistance not detected Rif resistance detected Treat as MDRTB Retreat with 1st line drugs and Check for INH resistance and treat • In case interruption happens in CP & on retrieval, the patient has no clinical evidence of active disease & tests for DRTB are negative, the remaining treatment course to be completed • Resons for interruption should always be evaluated & addressed in all cases (Address myths/fear or any intolerance) Interruption over 4 weeks Fibrocavitary shadows |