{"id":1121,"date":"2013-10-10T18:38:07","date_gmt":"2013-10-10T18:38:07","guid":{"rendered":"http:\/\/jacobimed.org\/NS\/?page_id=1121"},"modified":"2013-10-10T18:38:07","modified_gmt":"2013-10-10T18:38:07","slug":"ppd-presentation","status":"publish","type":"page","link":"https:\/\/jacobimed.org\/old\/ambulatory\/mlove\/curriculumprevention\/tuberculosis-screening\/ppd-presentation\/","title":{"rendered":"PPD Presentation"},"content":{"rendered":"

 <\/p>\n

\n

The PPD <\/span><\/h1>\n

\n

prepared by C.Chong<\/span><\/p>\n

\u00a0<\/span><\/p>\n

Goal<\/span>
\n— the rational use of the PPD<\/span><\/p>\n

\n\n\n\n
\n

Learning
\nObjectives:<\/span><\/p>\n

1.\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>epidemiology of
\ntuberculosis<\/span><\/p>\n

2.\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>indications for screening
\n– public health considerations, comorbidities<\/span>,
\nhealth maintenance<\/span><\/p>\n

3.\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>interpretation – comorbidities<\/span>, BCG, risk<\/span><\/p>\n

4.\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>prophylaxis – when and
\nwhat<\/span><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\u00a0<\/span><\/p>\n

<\/h4>\n

Readings<\/span><\/h4>\n

\n

1..<\/span><\/span> Targeted Tuberculin Testing
\nand Treatment of Latent Tuberculosis Infection, CDC MMWR June 9, 2000 \/ Vol. 49
\n\/ No. RR-6<\/a> <\/span><\/p>\n

\u00a0<\/span><\/p>\n

2.<\/span> CITY HEALTH INFORMATION
\nTHE NEW YORK CITY DEPARTMENT OF HEALTH\u00a0 <\/span>Testing<\/span> and Treatment for Latent
\nTuberculosis Infection October 2000 Vol. 19
\n<\/span>No. 3<\/a><\/span><\/p>\n

\u00a0<\/span><\/strong><\/p>\n

3.
\nPPD in a nutshell, C.Chong<\/span><\/a><\/span><\/p>\n

\u00a0<\/span><\/p>\n

Cases<\/span><\/h2>\n

\u00a0<\/span><\/p>\n

Answer
\nthe FIRST FIVE questions in the City
\nHealth Information handout<\/a>.\u00a0 <\/span><\/span>\u00a0\u00a0<\/span>ANSWERS<\/a><\/span><\/span><\/strong><\/p>\n

\u00a0<\/span><\/p>\n

Now
\nanswer the following questions.\u00a0 <\/span><\/span><\/p>\n

\u00a0<\/span><\/p>\n

1.\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>An 18 year old male comes comes<\/span> to your office for a physical examination prior to
\nstarting college away from home.\u00a0 <\/span>PPD is
\nlisted under optional tests.\u00a0\u00a0 <\/span>Should you
\nplant a PPD? ANSWER<\/a><\/span><\/span><\/p>\n

2.\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>A 26 y.o<\/span>.
\nfemale newly immigrated<\/span> from Mexico has a +
\nPPD; she is also pregnant.\u00a0 <\/span>She never had
\na TB test before.\u00a0 <\/span>She otherwise has no
\nother medical problems.\u00a0 <\/span>What is your
\nmanagement? ANSWER<\/a><\/span>
\n<\/span><\/span><\/p>\n

3.\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>A 47 y.o<\/span>.
\ndiabetic has 11-mm induration<\/span> at the PPD site.\u00a0 <\/span>The chart states \u201cnegative PPD\u201d 1 year
\nago.\u00a0 <\/span>What is your plan? ANSWER<\/a><\/span><\/span><\/p>\n

4.\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>A 37 y.o<\/span>.
\nmale\u2019s room mate was diagnosed with active TB last week.\u00a0 <\/span>He is well but concerned about his risk.\u00a0 <\/span>What do you offer him?\u00a0 <\/span>His records indicate he was PPD negative 3 years<\/span> ago.\u00a0 <\/span>You plant
\na PPD and it is negative.\u00a0 <\/span>What advice do
\nyou give him? ANSWER<\/a><\/span><\/span><\/p>\n

5.\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>A 40 y.o<\/span>.
\nfemale with SLE x 15 years has been on chronic steroids for the past three years.\u00a0 <\/span>She presents with a 10 lb weight loss, night
\nsweats and cough with occasionally blood-tinged sputum for 3 weeks.\u00a0 <\/span>What is your differential?\u00a0\u00a0 <\/span>What tests do you request?\u00a0 <\/span>Her CXR shows hilar<\/span>
\nadenopathy<\/span>, right apical streaking and
\n?<\/span> a<\/span> right cavitary<\/span> lesion.\u00a0 <\/span>Her PPD is negative.\u00a0 <\/span>What is your plan? ANSWER<\/a><\/span><\/span><\/p>\n

6.\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>A 39 y.o<\/span>.
\nwho immigrated<\/span> from China three years ago presents with
\na cough and 14-mm PPD.\u00a0 <\/span>The CXR is
\nnegative.\u00a0 <\/span>What is your plan? ANSWER<\/span><\/a><\/span><\/p>\n

7.\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>A 39 y.o<\/span>.
\nhealth care worker has an employment physical which requests TB testing.\u00a0 <\/span>She recalls a + PPD \u201cyears ago\u201d and being
\ntold never to repeat the test.\u00a0 <\/span>She is
\nclinically well.\u00a0 <\/span>What do you do?\u00a0 <\/span>ANSWER<\/span><\/a><\/span><\/p>\n

8.
\n<\/span><\/span><\/span>A 43 y.o<\/span>. IVDA presents for a physical prior
\nto entering a residential rehab program.
\n<\/span>He is otherwise well.\u00a0 <\/span>Should a
\nPPD be planted?\u00a0 <\/span>The PPD is 6 mm.\u00a0 <\/span>What do you plan? ANSWER<\/a><\/span><\/span><\/p>\n

9.
\n<\/span><\/span><\/span>You are working in HIV clinic with continuity patients who are doing
\nwell on their cocktail.\u00a0 <\/span>Your boss is mad
\nbecause a chart audit revealed their last PPD\u2019s<\/span> were
\n2 years ago.\u00a0 <\/span>Is your boss just picking
\non you?\u00a0\u00a0\u00a0\u00a0<\/span>ANSWER<\/a><\/span><\/span><\/p>\n

10.\u00a0 <\/span><\/span><\/span>Mr. T was hospitalized for
\nCHF and COPD on 3E.\u00a0 <\/span>The medical student
\nsent sputum for AFB because his CXR didn\u2019t clear completely and he had a<\/span> h\/o a cough productive of blood flecked sputum.\u00a0 <\/span>6 weeks later, it is positive.\u00a0\u00a0 <\/span>What now?
\n<\/span>ANSWER<\/a><\/span><\/span><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

  The PPD prepared by C.Chong \u00a0 Goal — the rational use of the PPD Learning Objectives: 1.\u00a0\u00a0\u00a0\u00a0\u00a0 epidemiology of tuberculosis 2.\u00a0\u00a0\u00a0\u00a0\u00a0 indications for screening – public health considerations, comorbidities, health maintenance 3.\u00a0\u00a0\u00a0\u00a0\u00a0 interpretation – comorbidities, BCG, risk 4.\u00a0\u00a0\u00a0\u00a0\u00a0 prophylaxis – when and what \u00a0 Readings 1.. Targeted Tuberculin Testing and Treatment of Latent Tuberculosis….<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":1119,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"footnotes":""},"class_list":["post-1121","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/pages\/1121","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/comments?post=1121"}],"version-history":[{"count":1,"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/pages\/1121\/revisions"}],"predecessor-version":[{"id":1122,"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/pages\/1121\/revisions\/1122"}],"up":[{"embeddable":true,"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/pages\/1119"}],"wp:attachment":[{"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/media?parent=1121"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}