Dr. AG 

CORRECT ANSWER:C) Re-administer the PPD test

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Dr.K.G.MoniGandhi

EXPLAINATION FOR ANSWER:

1. WHEAL SIZE: The wheal size should be 6mm or greater. If it is less than 6 mm, this often indicates that the injection was given too deep. (6-10 mm is ideal).

2. WHAT IS IT: The tuberculin purified protein derivative-PPD, is a screening test used to determine if patient potentially has TB. It is not a perfect test. False positives do sometimes occur. Further tests should be done if reads positive.

3. ADMINISTRATION: PPD should be given intradermally. Intradermal injections are given at a 5-15 degree angle. The bevel of the needle should face upwards.

4. RETURN TIME: Once it is give, the individual should return working 48-72 hours.

5. READING THE TEST: When patient returns, the provider is examining the area for induration (raised hardened area) at the site of the original injection. Providers sometimes make the mistake of simply looking for redness at the site. Induration is what should be evaluated and sometimes cannot simply be looked at to determine if present.

6. POSITIVE TEST: 15mm in anyone would be considered a positive test. For moderate risk groups that criteria is bumped down to 10mm indicates a positive. And high risk 5mm indicates a positive.

7. MISSED READ TIME FRAME: If the patient misses the 48-72 hour read window-they will have to have the test re-administered. There is no wait time for this re-administration.

8. PRESSURE: should not be held over this site of administration unless significant bleeding develops (usually doesn’t happen).

9. SOME NAMES FOR THE TEST: Mantoux test, TB skin test, PPD test, Tuberculin tests

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