Tuberculosis

Comprehensive review article on tuberculosis from NEJM by Zumla et al, 2013.

Related: An article from Journal of ID, Metcalfe, et al. 2011, re: the use of inteferon-gamma release assays in diagnosis of active pulmonary TB.

CME Questions for this article from the NEJM website:

1. Risk of developing active TB among pt's with latent infection?
2. Which is true re: diagnosis of latent or active TB?
1. TB skin test is as specific as interferon-gamma release assay but less sensitive in diagnosing latent TB. 
2. solid culture medium is the standard for diagnosis of active TB. 
3. interferon gamma release assays are useful in the diagnosis of active TB. 
4. the Xpert MTB/RIF assay test is more sensitive than smear microscopy. 
3. Which is true re: HIV & TB coinfection?
1. Early ART therapy has no effect on mortality. 
2. Early ART therapy improves outcomes in pts with TB meningitis. 
3. IRIS occurs in at least 10% of HIV-infected patients who start ART during TB treatment. 
4. The most common manifestation of IRIS is a maculopapular rash.