Step II Question about PPDs

[evilbooyaa]

MTB 2 says that a positive PPD with a negative CXR = 9 months INH. It also says that once a PPD is positive, it will always be positive, and shouldn't be repeated. Does this mean that if someone received the BCG (and thus has a positive PPD) they get 9 months of INH every year (assuming they are required to get a PPD every year)? Seems a bit excessive for a pretty non-benign drug.

 

[link2swim06]

MTB 2 says that a positive PPD with a negative CXR = 9 months INH. It also says that once a PPD is positive, it will always be positive, and shouldn't be repeated. Does this mean that if someone received the BCG (and thus has a positive PPD) they get 9 months of INH every year (assuming they are required to get a PPD every year)? Seems a bit excessive for a pretty non-benign drug.

In practice no. There was just a thread in allo about PPD. Ideally a person with a BCG would be getting a quantiferon gold not a PPD and therefore test negative.

However, I have no clue what the 'NBME' answer to your is...

 

[Ronin786]

MTB states that the BCG is treated the same as a non-BCG. Basically, if the guy has taken the BCG and it is positive then it is still considered positive and you give him INH.

Obviously if he was treated previously and is coming in again, you're going to be looking for another way to check his TB status outside of PPD.

 

[evilbooyaa]

MTB states that the BCG is treated the same as a non-BCG. Basically, if the guy has taken the BCG and it is positive then it is still considered positive and you give him INH.

Obviously if he was treated previously and is coming in again, you're going to be looking for another way to check his TB status outside of PPD.

Alright, that's the answer I was looking for. It didn't make sense to me for the situation I typed above, but I realized I had never learned about the f/u that happens after 9 months of INH for people with a positive PPD and negative CXR.