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Pneumonia and tuberculosis

A practice question in the style of the PLAB 1 exam. Choose your answer to see the explanation.

A 33-year-old has had a productive cough for 5 weeks, night sweats and weight loss. Chest X-ray shows right upper lobe cavitation. What is the most important next step?

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The answer is A: At least three sputum samples for acid-fast bacilli.

Suspected pulmonary TB needs at least three sputum samples, one early morning, for smear, culture and a rapid molecular test, before treatment starts. Isolation is considered until infectivity is excluded.

This question comes from Week 2 of PLAB Vault: Respiratory. That week has 124 more exam-style questions like it, 5 short lessons and 154 flashcards. The course starts free with Week 1 and reaches this topic in week 2, as part of a four-month plan with full mock exams along the way.

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