Tuberculosis

A 50-year-old man with a history of diabetes presents with a chronic productive cough, fever, and weight loss. He reports contact with a known tuberculosis patient. On examination, there are coarse crackles in the upper right lung. His observations are: heart rate 95 bpm, respiratory rate 22 breaths per minute, blood pressure 130/85 mmHg, and oxygen saturation 94% on room air. A chest X-ray shows a right upper lobe consolidation. Sputum smear microscopy is positive for acid-fast bacilli.

What is the first-line treatment regimen for this patient?

A 28-year-old woman presents with a 2-month history of persistent cough, low-grade fever, night sweats, and fatigue. She has no significant medical history but recently returned from traveling in Southeast Asia. On examination, she has mild lymphadenopathy and fine crackles in the upper lobes. Her observations are: heart rate 85 bpm, respiratory rate 18 breaths per minute, blood pressure 115/70 mmHg, and oxygen saturation 98% on room air. A sputum sample is taken for analysis.

Which of the following tests is most definitive for diagnosing active pulmonary tuberculosis?

A 25-year-old woman who recently immigrated from a country with a high prevalence of tuberculosis has a positive IGRA test during a pre-employment screening. She has no symptoms and a clear chest X-ray. She is diagnosed with latent tuberculosis infection (LTBI) and asks about her treatment options.

What is the most appropriate treatment regimen for latent tuberculosis infection in this patient?

A 60-year-old man with active pulmonary tuberculosis is being treated with isoniazid, rifampicin, pyrazinamide, and ethambutol. He reports dark urine and jaundice after two months of therapy. Liver function tests show markedly elevated transaminases.

What is the most appropriate next step in the management of his tuberculosis?

A 45-year-old man presents to the clinic with a 3-month history of persistent cough, unintentional weight loss, night sweats, and occasional haemoptysis. He recently immigrated from a country with a high prevalence of tuberculosis. On examination, he appears thin and febrile, with crackles in the upper zones of both lungs. His observations are: heart rate 90 bpm, respiratory rate 20 breaths per minute, blood pressure 120/75 mmHg, and oxygen saturation 97% on room air. A chest X-ray shows cavitary lesions in the right upper lobe.

What is the most likely diagnosis?