TB

A 26-year-old Indian gentleman, known schizophrenia presented to you in a Klinik Kesihatan. He was bought in by his relative with the complaints of being aggressive at home. The patient was restless and uncooperative during the consultation. Hence you decided to refer the patient to the Hospital. At the Emergency Dept, the patient was triaged to the Yellow Zone (Immediate care) in view of his mental state. Upon further questioning by the medical officer on duty, he admitted to have x1/12 ho dry cough associated with on and off fever. He also had loss of appetite and loss of weight within that 1 month period. However, he denied any night sweats, haemoptysis or any TB contact. He also complained of shortness of breath which is progressively worsening over the past x1/52. Below is his CXR done in the Emergency Dept:

Question 1: What are the findings of his CXR?

Question 2: What are the differential diagnoses (prolonged cough)?

Question 3: Lets say the patient was stable, did not have schizophrenia and was not aggressive on presenting to you at the Klinik Kesihatan with the above complaints, how would you approach and manage this patient?

Question 4: If he was confirmed to have pTB, how would you screen his wife and 3 years old child for TB?

Drug Discussion: What are the anti-TB medications and regime available? What are the drugs' mode of action and common side effects?