QBank Fortnightly Newsletter

VOLUME: 1, ISSUE: 5

Hello!

In our 5th issue, we bring some more updates from the world of Qbank based on a couple of important recent updates.

Please have a look. 

1. NTEP 2020 recommendation

(Updated- MCQ id: MB8289. Pearl id: 1720)

As per the latest recommendations from the National Tuberculosis Elimination Programme 2020 (NTEP 2020), the treatment of TB will be based primarily on drug susceptibility testing. It is irrespective of new cases, previously treated cases or recurrent TB cases. 

All cases of TB will be treated with Drug Sensitive TB Regimen, as long as the patient is sensitive to isoniazid and rifampicin. (No classification into the category I or II)

Type of TB CaseIntensive PhaseContinuation Phase
New and previously treated cases (H and R sensitive)2 H R Z E4 H R E

H: Isoniazid; R: Rifampicin; E: Ethambutol; Z: Pyrazinamide

Daily Dose Schedule for Adults (as per weight bands) (MCQ id: MD0983)

Weight categoryNo. of tabletsNo. of tablets
Intensive phase
HRZE
(dose: 75/150/400/275)
Continuation phase HRE 
(dose: 75/150/275)
25-34 kg22
35-49 kg33
50-64 kg44
65-75 kg55
>75 kg 66

Classification based on drug resistance (DR) (MCQ id: MA2040)

  • Mono-resistant (MR): Resistant to one 1st line anti-TB drug only.
  • Poly-Drug Resistant (PDR): resistant to more than one 1st line anti-TB drug, other than Rifampicin. 
  • Rifampicin Resistant (RR): Resistant to rifampicin with or without resistance to other drugs. Patients, who have rifampicin resistance, should be managed as if they are an MDR TB case.
  • Multi-Drug Resistant (MDR): Resistant to both isoniazid and rifampicin.
  • Extensively Drug-Resistant (XDR): Resistant to a fluoroquinolone (ofloxacin, levofloxacin, or moxifloxacin) and a second-line injectable anti TB drug (kanamycin, amikacin, or capreomycin).

Standard DR TB regimen (MCQ id: MC7007, MB8290, MB8291)

Regimen classDrugsComments
H mono-resistant/ poly-drug resistant TB regimenLfx R E Z for 6 months6 months long.
Oral drugs only
Shorter MDR TB regimenIntensive Phase: Mfx Km/Am Eto Cfz Z H E for 4-6 months

Continuation phase: Mfx Cfz Z E for 5 months
9-11 months long.
Injectables used in the intensive phase.
Longer MDR TB regimenBdq (6 months) Lfx Lzd Cfz Cs for 18-20 months18-20 months long Oral drugs only.
This regimen is used for XDR TB patients for 20 months.

FQ: Fluoroquinolone; SLI: Second Line Injectable; PLHIV: People Living with HIV; Lfx: Levofloxacin; H: Isoniazid; R: Rifampicin; E: Ethambutol; Z: Pyrazinamide; Mfx: Moxifloxacin; Km: Kanamycin; Am: Amikacin; Eto: Ethionamide; Cfz: Clofazimine; Bdq: Bedaquiline; Lzd: Linezolid; Cs: Cycloserine

Criteria for patients to receive standard Drug Resistant TB regimen
Standard Drug-Resistant TB regimenInclusion criteriaExclusion criteria
H mono-resistant/poly-drug resistant TB regimenIsoniazid resistant TB with rifampicin sensitiveNo specific criteria
Shorter MDR TB regimenPatient with rifampicin-resistant pulmonary or extra-pulmonary TBNon-drug sensitivity test-based criteria:
Pregnancy, Any extrapulmonary disease in PLHIV, Disseminated meningeal or central nervous system TB, Intolerance to any drug in the shorter MDR TB regimen
Drug sensitivity test-based criteria:
If DST/DRT result for FQ or SLI is resistant (XDR TB), the presence of InhA mutation, Resistant to Z 
Longer MDR TB regimenPatients in whom shorter MDR TB regimen cannot be considered due to any reasonNone

Ref: http://www.tbcindia.nic.in/WriteReadData/NTEPTrainingModules1to4.pdf

2. CEAP Classification 2020

(MCQ id: MB7659, MC7490) (Updated pearl id: 2292,1747)

The American Venous Forum has revised the CEAP classification system for Chronic Venous Disease. The ‘C’ (Clinical class) component has new inclusions, as highlighted in the table below. The Etiology (‘E’), Anatomical distribution (‘A’) and Pathophysiology (‘P’) based classes remain the same.

Currently, the clinical categories are recognized as follows: 

C0No visible or palpable signs of venous disease
C1Telangiectasis or reticular veins
C2Varicose veins
C2rRecurrent varicose veins
C3Edema
C4
C4aC4bC4c
Changes in skin and subcutaneous tissues secondary to chronic venous disease: Pigmentation or eczemaLipodermatosclerosis or atrophie blanche Corona phlebectatica
C5Healed
C6Active venous ulcer
C6rRecurrent active venous ulcer 

Ref: https://www.jvsvenous.org/article/S2213-333X(20)30063-9/fulltext

Click here to check out the previous issues of the newsletters:

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51 Responses

  1. Dr gitanjali says:

    Thanks for these updates . How can I save it for revision purpose

  2. Alisha says:

    How can I get the previous issues. I’ve missed them. Please help.

  3. Dr.Neeraj Ramteke says:

    Thnx for update.

  4. Nischay keshri says:

    Nice information

  5. Kumar says:

    Thanks for the info

  6. Shubham jaybhaye says:

    Thanks for update

  7. Kaushikkotwal says:

    Click on 3 horizontal lines , top right >Blog

  8. Praveen says:

    Thank you .how can I save them

  9. Poonam says:

    It is very helpful to us .. thank u team marrow..

  10. Tejas says:

    First you copy the link, the open in google chrome, then click in 3 button menu list, click on share, choose print option, then you can download this as pdf form.

  11. Kousik Maity says:

    Thanks for the update 🙏

  12. Baba Kolhal says:

    Thanks Marrow for updating

  13. Haritha says:

    Just awesome

  14. Tmd says:

    Thank you so much for the news letters 🙏🙏

  15. Sravya says:

    Thank you marrow ….

  16. Amit says:

    How i get a prv updates.

  17. Dr Lily Swain says:

    Thanks!

  18. Greeshma Valaboju says:

    Thanks for updates

  19. Ankita Patel says:

    Thank u for this update .
    i request to update about Hypertension classification , there is different range in different classification, and its confusing to follow which classification….
    Please, guide us
    Thank u.

  20. Jackson Reang says:

    I am fortunate to have not missed this updates on NTEP 2020

  21. M.Harika says:

    Thanks for updating

  22. Satyam parmar says:

    Thanks marrow for updating us

  23. VENGADAJOTHI says:

    Thanks for updating …

  24. Chinmay Tiwari says:

    Thanks. Can you give updates about extrapulmonary manifestation of Coronavirus ?

  25. Pallavi vyas says:

    How we can save them pls tell I have missed previous ones also

  26. Amreen khan says:

    These updates all together if revised just before exams will be very helpful kindly keep them in revision module.

  27. Mohit says:

    Newsletter is lifesaver because indirectly it saves a lot of time wasted searching something on FB group

  28. Famara says:

    Excellent thing

  29. Devashish verma says:

    Thanks a lot

  30. phoebe buffay says:

    Thanks

  31. Thank U Marrow Team for this latest update.

  32. Achchhan Khan says:

    Awesome knowledge

  33. Pritam Dey says:

    Thank you Team Marrow for the latest updates 💐

  34. kanaram sharma says:

    thanks a lot 😊😊

  35. Sulakshana mitra says:

    Thnku team Marrow for such latest updates

  36. Soma Sundaram says:

    Thanks for new updates

  37. Dr Amar says:

    Thank u very much for update sir/maam

  38. Samah says:

    Thank you for the update. Is there a way of accessing the previous newsletters?

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