Comprehensive Respiratory System Disorders Q 39 - Gyan Darpan : Learning Portal
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Friday, 22 April 2022

Comprehensive Respiratory System Disorders Q 39

A nurse performs an admission assessment on a female client with a diagnosis of tuberculosis. The nurse reviews the result of which diagnosis test that will confirm this diagnosis?
     A. Bronchoscopy
     B. Sputum culture
     C. Chest x-ray
     D. Tuberculin skin test

Correct Answer: B. Sputum culture

Tuberculosis is definitively diagnosed through culture and isolation of Mycobacterium tuberculosis. Mycobacterial culture is the gold standard for diagnosis. Mycobacterial culture should be performed on both the solid and liquid medium. Liquid media culture can detect very low bacterial load and is considered a gold standard. Culture essential for drug susceptibility testing. A presumptive diagnosis is made based on a tuberculin skin test, a sputum smear that is positive for acid-fast bacteria, a chest x-ray, and histological evidence of granulomatous disease on biopsy. Active tuberculosis is diagnosed by isolating Mycobacterium tuberculosis complex bacilli from bodily secretions.

Option A: If all measures fail to obtain a sputum sample, a fiberoptic bronchoscopy with bronchoalveolar lavage can be performed with or without a transbronchial biopsy. Bronchoscopy can also be performed in high clinical suspicion with negative sputum studies and to rule out an alternative diagnosis.
Option C: Primary tuberculosis often causes middle and lower lung field opacities associated with mediastinal adenopathy. Whereas secondary tuberculosis commonly involves upper lobes, causing opacities, cavities, or fibrotic scar tissue.
Option D: The Mantoux test is a two-part test consisting of an intradermal injection of .1ml purified protein derivative and observing for induration 48-72 hours. The patient’s risk of exposure is taken into consideration when interpreting the result. Patients are then classified into three groups based on the size of the induration and the risk of exposure.

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