Which is a true statement about tuberculosis (TB) in older adults?
a. The principal threat from tuberculosis is its highly contagious nature.
b. The tuberculin purified protein derivative (PPD) test is a conclusive test for TB.
c. Antimicrobial drugs have made tuberculosis a thing of the past.
d. Older persons, particularly those in nursing homes, are at risk for tuberculosis.
D
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A Incorrect. TB is not as contagious as formerly supposed, but drug-resistant forms exist and are a serious risk for elders who are immunocompromised.
B Incorrect. A PPD test has a false-negative rate of approximately 30%. When the result is positive, the patient receives a sputum culture and chest x-ray exam. A positive sputum culture is necessary to confirm the diagnosis.
C Incorrect. Although medications such as isoniazid (INH) were thought to have eliminated TB, the organism is present in multidrug-resistant forms.
D Correct. Elders who contracted TB before the 1940s may suffer reactivation of the bacterium. Most reported cases of TB among elders are from nursing homes.
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