Which of the following is a common symptom of active tuberculosis?

Appeared in: NHM UP Staff Nurse - 2017

Explanation

Marked weight loss is a classic constitutional symptom of active tuberculosis, often referred to as a 'wasting' disease.
It occurs due to the systemic inflammatory response, increased metabolic rate, and decreased appetite (anorexia) caused by the infection.
This symptom is frequently accompanied by other constitutional signs like low-grade fever, night sweats, and fatigue.

Option B: This indicates advanced or extensive pulmonary disease, pleural effusion, or miliary TB. It is not a common initial symptom.
Option C: This is a specific and alarming sign of central nervous system involvement, most commonly tuberculous (TB) meningitis.
Option D: Gastrointestinal symptoms with TB are uncommon, and when they occur, they are more likely to be diarrhea or abdominal pain, not constipation.

Clinical Relevance

Nursing practice connection: Knowing Clinical manifestations of active tuberculosis helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses must have a high index of suspicion for TB in patients presenting with unexplained weight loss, persistent cough, and fever, especially in high-risk populations.
Implementing airborne precautions immediately for suspected TB cases is a critical patient and staff safety measure to prevent nosocomial transmission.
What if? If the patient also presented with a severe headache and neck stiffness, the priority would shift to investigating for TB meningitis, and a lumbar puncture would be indicated, making 'mental status change' a highly significant finding.

How to Approach the Question

First, identify the core of the question: it asks for a 'common' symptom of active TB.
Analyze the options to differentiate between common, systemic symptoms and symptoms of advanced or complicated disease.
Recall the classic constitutional 'B symptoms' associated with TB and other chronic infections: fever, night sweats, and weight loss.
Evaluate 'Marked weight loss' as a classic constitutional symptom.
Evaluate the other options: 'Dyspnoea' suggests advanced lung damage, and 'mental status change' points to a specific complication (meningitis). 'Constipation' is not a typical symptom.
Conclude that marked weight loss is the most fitting answer for a 'common' symptom compared to the others which are signs of severity or specific complications.

Concept Tested & Keywords

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E6 Medicine Harrison 22e Part 1 p. 1428-1430

E6 Medicine Davidson Principles Practice 24e p. 610-612

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