A 45-year-old Inuit woman living in a remote Arctic community presents with a chronic cough and 5 kg weight loss over 3 months. She lives in crowded h...

Question

A 45-year-old Inuit woman living in a remote Arctic community presents with a chronic cough and 5 kg weight loss over 3 months. She lives in crowded housing with multiple family members. Smoking history is minimal. According to Canadian TB control principles and Indigenous health considerations, what is the most appropriate next step?

Accepted Answer

Arrange sputum smear and culture for Mycobacterium tuberculosis and chest radiograph, and coordinate with public health for contact tracing if confirmed.

Answer

Reassure her that TB is rare in Canada and treat empirically for asthma.

Answer

Start broad-spectrum oral antibiotics for presumed bacterial bronchitis and review in 3 months.

Answer

Advise her to move to an urban centre before any investigations.

Answer

Prescribe inhaled corticosteroids without further workup.

ca-mccqe1 MCQ (SBA): Pulmonary tuberculosis in Indigenous patient