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Pulmonary tuberculosis — SCE Respiratory MCQ

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ModerateRespiratory InfectionsPulmonary tuberculosisSCE Respiratory

A 32-year-old man has 3 months of cough, night sweats and weight loss. CXR shows right upper-lobe cavitation. He is born in a high-incidence country and HIV test is negative. Sputum smear is AFB positive and PCR confirms rifampicin-sensitive Mycobacterium tuberculosis. What is the most appropriate management?

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Correct answer: A — Rifampicin, isoniazid, pyrazinamide and ethambutol initially with public health notification

Pulmonary TB is treated initially with four-drug therapy while public health notification and contact tracing are arranged. Two-drug therapy is the continuation phase, not the initial phase for active pulmonary TB. Waiting for full culture sensitivity would delay treatment and increase transmission risk.

Reference: NICE NG33; BNF Tuberculosis treatment summary