Quiz 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