A 40-year old patient presents with symptoms suggestive of tuberculosis (TB). What is the confirmatory test for TB?
Interferon Gamma Release Assays (IGRAS)
Sputum culture
Tuberculin Skin Test (TST)
Chest X-ray
The Correct Answer is B
A. Interferon Gamma Release Assays (IGRAs): IGRAs are useful for detecting TB infection but do not confirm active TB disease. They measure the immune response to TB bacteria but don’t differentiate between latent and active infection.
B. Sputum culture: Sputum culture is the gold standard for confirming active TB because it identifies Mycobacterium tuberculosis bacteria directly, confirming active infection.
C. Tuberculin Skin Test (TST): The TST can indicate TB infection but cannot distinguish between latent and active TB, making it unsuitable as a confirmatory test for active disease.
D. Chest X-ray: A chest X-ray can show signs suggestive of TB but cannot confirm the presence of TB bacteria, so it is not definitive for diagnosing active TB.
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Correct Answer is C
Explanation
A. "I should monitor my temperature regularly and report any fevers to my healthcare provider." This statement shows correct understanding. Fever may indicate worsening infection or complications, so it’s important to monitor and report any fevers.
B. "I need to inform my healthcare provider about any new symptoms, such as shortness of breath or chest pain." This statement shows understanding. New symptoms, especially respiratory or cardiac, could signify complications, and should be reported.
C. "I can stop taking my antibiotics once I feel better." This indicates a need for further teaching. Completing the full course of antibiotics is crucial to ensure the infection is completely eradicated, even if symptoms improve.
D. "I will need to take antibiotics before dental procedures." Patients with infective endocarditis often require prophylactic antibiotics before dental procedures to prevent bacterial entry into the bloodstream.
Correct Answer is D
Explanation
A. Include high-fat foods to maintain weight. High-fat foods can worsen symptoms in ulcerative colitis by increasing bowel irritation and causing malabsorption. A balanced diet that is low in fat is usually recommended.
B. Eat three large meals a day to ensure adequate nutrition. Large meals can increase digestive workload and exacerbate symptoms. Smaller, more frequent meals are generally better tolerated.
C. Increase intake of dairy products to boost calcium levels. Many patients with ulcerative colitis are lactose intolerant or sensitive to dairy, which can worsen symptoms. Calcium can be obtained from other sources if needed.
D. Consume a low-fiber diet to minimize bowel irritation. A low-fiber diet can reduce mechanical irritation in the bowel, which is beneficial during flare-ups of ulcerative colitis.