B.A. is a natural-born American and has no risk factors for TB infection according to the CDC guidelines. She has a 6-year history of type II diabetes mellitus that is well controlled with metformin (Glucophage)
She admits that her mother had TB when she was a child but says she herself has never tested positive
before. She is angry at the proposition that she might have TB and says, "I feel just fine and I don't think
anything else is necessary."
What steps need to be done to determine whether B.A. has an active TB infection?
First, B.A. will need a CXR examination. For persons with reactions greater than or equal to 10 mm
and persons with symptoms suggesting TB (e.g., cough, anorexia, weight loss, fever)—regardless
of the size of the skin-test reaction—this should be done within 72 hours. If the CXR examination
is abnormal and/or symptoms compatible with TB are present, the patient should undergo sputum
smear and culture examinations. At least three sputum specimens should be submitted.
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A school nurse is presenting information on human development and sexuality
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