Typical exam stem
A patient has chronic cough, weight loss, night sweats and an abnormal chest radiograph. How would you investigate and manage suspected pulmonary TB?
Active exam mode
Plan the case before reading, then mark sections, reveal pearls and self-rate the viva.
1. Sixty-second answer plan
1:00Before reading the notes, say or write your assessment, investigations and management structure.
2. Section checklist
Mark each section only after you can explain its main decision points without reading.
3. Exam-pearl flashcards
Try to predict the pearl before revealing it.
4. Viva drill
Answer aloud before rating yourself. Anything marked “review” stays visible in your progress.
Why are rapid molecular tests important in TB?
Progress is saved on this device. Use “Reset session” when you want a fresh attempt.
Confirm disease microbiologically when possible
Symptoms and radiology may strongly suggest tuberculosis, but bacteriological confirmation is important because it confirms the diagnosis and allows early detection of drug resistance. Use a WHO-recommended rapid molecular test as the initial diagnostic test where available, particularly when pulmonary TB is suspected.
Assessment should extend beyond the lungs
- Ask about HIV status, previous TB treatment, household exposure and drug-resistance risk.
- Consider extrapulmonary disease when there are lymph-node, pleural, neurological, abdominal, skeletal or pericardial features.
- Test for HIV according to local policy because coinfection changes prognosis and care.
- Obtain appropriate specimens from the involved site rather than relying solely on sputum in extrapulmonary disease.
Treatment logic
Treatment depends on whether disease is drug-susceptible or drug-resistant, site of disease, age, pregnancy, HIV status and prior therapy. Avoid memorising an outdated regimen without context. State that treatment should follow the current national tuberculosis programme and WHO recommendations, with adherence support and monitoring for toxicity and clinical response.
Drug-resistant TB should be managed using rapid susceptibility information and an appropriate all-oral regimen selected through the national programme. Infection prevention and contact evaluation are part of good TB management and are commonly omitted in examination answers.
Guideline source for further reading
This page is an original exam-revision summary. For clinical decisions, use current local protocols and the primary guidance below.