Question about Medical Examine

O

orono

Registered Users (C)
Hi,

I have a question about Tuberculosis. Is the X-ray examination required for employee-based applicant? The docotor said that I should do the skin test first. If the skin test is positive, then the X-ray exam is required.

However, the instructions of Form I-693 (Rev. 04/25/02) state that: "One of the conditions you will be tested for is tuberculosis. If you are 15 years of age or older, you will be required to have a chest X-ray examination. Exception: If you are pregnant or applying for adjustment of status under the Immigration Reform and Control Act of 1986, you may choose to have either a chest X-ray or a tuberculin skin test."

What did you do for your Tuberculosis test? Eager to get your answer..

Thanks

Orono
 
>What did you do for your Tuberculosis test? Eager to get your answer
The TB test starts with the skin test. The X-ray is needed only if you fail the skin test.

> Is the X-ray examination required for employee-based applicant?
If your skin test reveals a swelling >= 15 mm, then yes, you need an X-ray. If the doctor finds any "white spots" in your lungs, you'll be asked to see a public health officer about it.

These decisions (skin test or X-ray) are not in your hands. The doctor will take care of them.
 
Bajis is basically correct.

The INS medical Examiner has the final say so in this issue. The PPD ( TB skin test positivity for Asian immigrants is 10 mm not 15 mm. but that is a purely technical point). YOU MUST KNOW YOUR RIGHTS IF YOU ARE SKIN TEST POSITIVE. YOU CAN REFUSE TREATMENT, AS THE TREATMENT IS POISONOUS TO THE LIVER. I would do the first test with the INS examiner and do subsequent follow ups with a private doctor to save yourself some money.
 
well if the PPD is positive then one has to do XRay of the chest if that negative then the person needs INH for 6 months which is not poisonous but can have some effect on the liver enzymes more common if used with other antiTB drugs
if a person knows that he/she is PPD positive then they should not get PPD as it will remain positive for rest of life.I donot know why people are so scared about PPD/INH prophylaxis
Hope this helps
 
I would like to clarify that drugs for TB are not poisonous to the liver. I think that is too strong a word to use. They could have an effect on the liver enzymes. Basically if treatment is initiated, the health dept. will always ask you about symptoms that would suggest that your liver is being adversely affected throughout your treatment. If at any point you experience any such symptoms, they will promptly test your blood for liver enzyme levels and if these are elevated, they will stop treatment. The younger you are, the better are the chances that absolutely nothing will happen to you.
Anyway, I think that if you have a positive test and an abnormal X-ray that suggests an active infection, then it is in your best interest both health-wise and immigration-wise to initiate the appropriate treatment. The benefits, especially for younger individuals, far outweigh the risks.
TB being a communicable disease of public health significance, I do believe that if you have a positive skin test and an abnormal chest x-ray that suggests that you have an active infection, you would have no choice legally but to get treated.
 
Too many cooks spoil the broth.

I see I've created a furore in this forum. I hope I can clarify my stance. I did a Community health project in a small village in India where I placed a 100 PPD'S on the highschool children in a local school. An amazing 30% were PPD positive some with a transverse induration of 25 mm !!!!! I CAN GUARANTEE YOU THAT MOST OF THEM IF YOU HAD FOLLOWED THEM FOR LONG ENOUGH WOULD NEVER DEVELOP ACTIVE T.B.If you look at the average Doctor in India who treats T.B or works with Patients with T.B ( I come from a home with over 9 Doctors and am also a Doctor ) many are PPD positive and with a healthy immune system never pick up T.B. Also the signs and symptoms of active T.B are pretty impressive with Fevers, chills and weight loss. HENCE I HOLD MY STANCE THAT A POSITIVE PPD WITH A NEGATIVE CHEST XRAY IS NOT A REASON TO INITIATE INH CHEMO PROPHYLAXIS. WITH MY BUSY LIFESTYLE I HAVE BETTER THINGS TO DO THAN TO BE SPENDING A FEW HOURS EVERY WEEK IN THE HEALTH DPT, GETTING MY BLOOD TESTED FOR HEPATITIS.
In my practice I DO NOT TREAT POSITIVE PPD patients unless the patient or his/her family requests it after I go over the pro's and cons. IT IS ABSOLUTELY THE PATIENTS PRIORITY TO REJECT TREATMENT FOR A POTENTIALLY HARMFUL THERAPY, especially if he/she is reliable and otherwise healthy.
 
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