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Test 2: Clinical presentation of childhood tuberculosis

Please choose the one most correct answer to each question or statement.

  1. A high index of suspicion:
    • Is important in making the correct diagnosis of tuberculosis
    • Is only useful in diagnosing tuberculosis in older children
    • Is only helpful in children with severe malnutrition
    • Is not helpful in diagnosing tuberculosis
  2. The most important step in making a clinical diagnosis of childhood tuberculosis is:
    • A careful history
    • A general examination
    • Listening to chest with a stethoscope
    • Special investigations
  3. What is an early symptom of tuberculosis?
    • Shortness of breath
    • Coughing blood
    • A severe headache
    • Poor weight gain
  4. Children with tuberculosis may present to the clinic with:
    • Sudden weight gain and oedema
    • A fever that fails to respond to antibiotics
    • A peeling rash of the hands and feet
    • Blood-stained urine
  5. Children presenting with tuberculosis have usually been unwell for:
    • Less than 24 hours
    • Only a few days
    • A few weeks
    • At least three months
  6. A common symptom of pulmonary tuberculosis in children is:
    • Chest pain
    • Persistent cough lasting more than two weeks
    • Night sweats
    • Difficulty breathing
  7. On clinical examination, young children with pulmonary tuberculosis often have:
    • Severe chest indrawing
    • Neck stiffness
    • Decreased air entry and dullness on one side of the chest
    • No abnormal clinical signs
  8. A typical sign of tuberculous pneumonia is:
    • Fast breathing
    • Wheeze
    • Stridor
    • Central cyanosis
  9. Enlarged lymph nodes due to tuberculosis usually are:
    • Not tender
    • Tender
    • Soft
    • Firm and matted
  10. A complication of enlarged tuberculous nodes in the neck is:
    • Cancer
    • Abscess and fistula formation
    • Bleeding
    • Compression of the airway
  11. What is a common cause of mildly enlarged axillary lymph nodes in young children?
    • Lymphoma
    • Tuberculosis
    • BCG
    • Leukaemia
  12. An early sign of tuberculous meningitis is:
    • Drowsiness in an ill child
    • Convulsions
    • Loss of vision
    • Very high temperature
  13. A late sign of tuberculous meningitis is:
    • Headache
    • Weakness of one side of the body (paralysis)
    • Irritability
    • Rash
  14. What is a common sign of abdominal tuberculosis?
    • Rectal bleeding
    • Diarrhoea
    • Abdominal distension
    • Weight gain
  15. What joints are often affected by bone tuberculosis?
    • The knee
    • The small joints of the hand
    • The jaw
    • The bones of the feet
  16. Bone tuberculosis usually develops:
    • At the same time as the primary TB infection
    • Six to eight weeks after the primary infection
    • Six months after the primary infection
    • Many years after the primary infection
  17. Spinal tuberculosis usually presents with:
    • A local deformity of the back due to collapse of a vertebra
    • Local pain and tenderness
    • Paralysis of both legs
    • Constipation
  18. Disseminated tuberculosis is more likely in:
    • Newborn infants
    • Children over the age of five years
    • Children who have HIV infection
    • Children with iron-deficiency anaemia
  19. With miliary tuberculosis:
    • Children have usually received BCG immunisation
    • TB infection has spread throughout both lungs
    • Children are usually not generally ill
    • The chest X-ray is normal
  20. Scoring systems to identify children with tuberculosis:
    • Are essential to make the diagnosis
    • Can be used instead of sputum examination
    • Can be used instead of a chest X-ray
    • Are not very accurate