NBME Step 2 CK Form 7 Treatment of latent tuberculosis now (NBME Answers)

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Retired NBME Step 2 CK Form 7 Answers

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submitted by jaypat(7)

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Latent TB Treatment:

≥5mm – HIV; Immunocompromised; Previously healed TB; Recent contacts
≥10mm – IV drug; Recent immigrants; High risk work or home; dz states (DM/Leukemia/ESRD); Kids < 4yrs
≥15mm – treat everyone

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submitted by ∗buttercup(18)

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In 85 percent of patients with latent TB, the chest radiograph is normal.

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submitted by ∗step_prep5(246)

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Patient with a positive PPD (>15 mm positive in all patients) who is asymptomatic and without CXR findings = Latent tuberculosis –> Treatment (especially on NBME exam)
Key idea: PPD induration (NOT erythema) required for positivity depends upon patient risk factors with >5 mm being positive in patients with significant immunosuppression (HIV, organ transplant, immunosuppressant meds), recent contact with patient with active TB or patients with CXR findings consistent with TB // >10 mm being positive for patients from Tb endemic countries, IVDU, residents of high-risk settings (prisons, nursing homes, homeless shelters, etc.), children < 4 years old and patients working in mycobacterial labs // >15 mm in all patients
Note: 3 treatment options for latent tuberculosis include (1) Isoniazid and rifapentine +/- pyridoxine (2) Isoniazid +/- pyridoxine (3) Rifampin

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