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Test 3: Diagnosis of childhood tuberculosis

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

  1. The clinical diagnosis of tuberculosis in children:
    • Is usually easy to confirm
    • Can be confirmed with a few special investigations
    • Is confirmed only when other infections have been excluded
    • Usually cannot be confirmed
  2. What is used in a Mantoux skin test?
    • Live TB bacilli
    • Tuberculin
    • Serum from a patient with tuberculosis
    • Serum from a patient who has been cured of tuberculosis
  3. The Mantoux skin test is done:
    • Intravenously
    • Intramuscularly
    • Subcutaneously
    • Intradermally
  4. When should a Mantoux skin test be read?
    • Immediately
    • At 24 hours
    • Between 48 and 72 hours
    • After five days
  5. A Mantoux skin test is positive when:
    • The area of induration is 0 to 4 mm.
    • The area of induration is 2 to 5 mm in HIV-infected children.
    • The area of induration is 10 mm or more in children without immunosuppression.
    • The area of redness is 15 mm or more.
  6. What does a positive Mantoux skin test indicate?
    • The child has tuberculosis
    • The child is immune to tuberculosis
    • The child is malnourished
    • The child has been infected with TB bacilli
  7. A negative Mantoux skin test is unreliable in:
    • Boys
    • Older children
    • Children with HIV infection
    • Children with mild undernutrition
  8. How is a sputum sample obtained in a young child?
    • By asking the child to cough.
    • By gastric aspirate.
    • By suctioning the nose
    • By collecting saliva
  9. Do sputum samples usually contain many TB bacilli in children with tuberculosis?
    • Always
    • Usually they do
    • Usually they do not
    • Never in children
  10. How can staff protect themselves against TB infection when collecting sputum?
    • Receive BCG immunisation
    • Take a short course of INH
    • Wear a N95 respirator
    • Keep all the windows closed
  11. The recommended initial laboratory test for confirming tuberculosis is:
    • smear microscopy
    • Line probe assay
    • Xpert MTB/RIF
    • TB culture
  12. How long does it take to get a sputum culture result with liquid culture medium?
    • Less than one week
    • One to two weeks
    • Two to three weeks
    • More than one month
  13. What is the most sensitive test on sputum for TB bacilli?
    • Staining the smear
    • Xpert MTB/RIF
    • A Heaf test
    • Culture
  14. A chest X-ray is:
    • Essential to diagnose tuberculosis
    • Very useful in diagnosing tuberculosis in children
    • Only useful in adults with tuberculosis who have lung cavities
    • No longer needed with modern sputum tests
  15. The commonest chest X-ray finding in children with tuberculosis is:
    • Enlarged hilar lymph nodes
    • The primary infection in the lung
    • Consolidation of the upper lobe of a lung
    • Bronchiectasis
  16. Many small spots throughout both lungs on a chest X-ray suggests:
    • Primary TB infection
    • Pleural effusion
    • Miliary tuberculosis
    • Patchy bronchopneumonia
  17. Fine needle aspiration is useful when diagnosing tuberculosis in:
    • The spleen
    • Enlarged lymph nodes
    • The lung
    • The spine
  18. When should a lumbar puncture be performed?
    • Only in children with disseminated tuberculosis
    • If spinal tuberculosis is suspected
    • To confirm a clinical diagnosis of tuberculous meningitis
    • If the Mantoux skin test is positive in an infant
  19. When should children with tuberculosis be screened for HIV?
    • All children suspected of having tuberculosis must be screened
    • Only in infants
    • Only in sexually active adolescents
    • Screening for HIV is not necessary
  20. What test should be used when diagnosing HIV infection in a child under 18 moths of age with tuberculosis?
    • Rapid HIV test
    • ELISA HIV test
    • HIV Western blot test
    • HIV PCR test