Pulmonary tuberculosis — MCCQE Part 1 MCQ

Correct answer: E — Place in airborne isolation and obtain sputum for acid-fast bacilli testing and TB nucleic acid amplification

Place in airborne isolation and obtain sputum for acid-fast bacilli testing and TB nucleic acid amplification is the single best answer because the age, timing, examination findings and investigations in the vignette fit Pulmonary tuberculosis better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian Tuberculosis Standards, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian Tuberculosis Standards