Phys Clinical Cases · infectious
Tuberculosis — DCE Clinical Case
DCE short-case station: respiratory examination of a patient with chronic apical changes after tuberculosis — apical crackles, bronchial breathing and volume loss, with a presentation template, the active-versus-inactive discrimination, and examiner questions.
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Target exams
FRACP DCEMRCP PACES
Prompt
DCE short-case station: respiratory examination of a patient with chronic apical changes after tuberculosis — apical crackles, bronchial breathing and volume loss, with a presentation template, the active-versus-inactive discrimination, and examiner questions.
The approach to this station
This is the classic "old TB" respiratory short case: the examiner wants a systematic examination, honest description of apical signs, and then — the actual test — your discrimination between inactive scarring and active disease, plus the differential of apical pathology [1].
References4ShowHide
- [1]Lewinsohn DM, Leonard MK, LoBue PA, et al. Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention Clinical Practice Guidelines: Diagnosis of Tuberculosis in Adults and Children Clin Infect Dis, 2017.PMID 28052967
- [2]Nahid P, Dorman SE, Alipanah N, et al. Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis Clin Infect Dis, 2016.PMID 27516382
- [3]Getahun H, Matteelli A, Chaisson RE, Raviglione M. Latent Mycobacterium tuberculosis infection N Engl J Med, 2015.PMID 26017823
- [4]Boehme CC, Nabeta P, Hillemann D, et al. Rapid molecular detection of tuberculosis and rifampin resistance N Engl J Med, 2010.PMID 20825313