Which of the following is a common symptom of TB?

Appeared in: UP CHO - 2018

Explanation

Marked weight loss is a classic constitutional symptom of active tuberculosis, often referred to historically as 'consumption'.
It results from the chronic inflammatory state and the release of cytokines (like TNF-alpha), which cause anorexia (loss of appetite) and increased catabolism.
Weight loss, along with low-grade fever and night sweats, forms a triad of systemic symptoms highly suggestive of TB.

Option B: Dyspnoea (shortness of breath) on exertion is not a common early symptom. It typically appears in advanced stages of pulmonary TB when there is extensive lung parenchymal damage, a large pleural effusion, or miliary (disseminated) disease.
Option C: Mental status change is an uncommon and serious symptom that points towards a complication, specifically extrapulmonary TB affecting the central nervous system (CNS), such as tuberculous meningitis.
Option D: Constipation is not a characteristic symptom of tuberculosis. While TB can affect the gastrointestinal tract, it more commonly presents with abdominal pain, diarrhea, or signs of obstruction.

Clinical Relevance

Nursing practice connection: Knowing Clinical Manifestations of Tuberculosis helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Recognizing constitutional symptoms like unexplained weight loss is a critical nursing responsibility for early case detection, especially in high-risk populations (e.g., immunocompromised, close contacts, residents of crowded settings).
Nurses should assess for the full triad of fever, night sweats, and weight loss when TB is suspected, as patients may not volunteer all information.
What if? If a patient presents with marked weight loss and a persistent cough lasting more than 2-3 weeks, the suspicion for active pulmonary TB is very high, and the nurse should ensure the patient is placed in respiratory isolation and sputum samples are collected for AFB testing.

How to Approach the Question

First, identify the keyword in the question stem: 'common'. This directs you to look for a symptom that is frequently present in typical cases of TB, rather than a rare symptom or one associated with complications.
Next, recall the classic clinical presentation of pulmonary tuberculosis.
Evaluate each option: 'Marked weight loss' is a well-known constitutional symptom. 'Dyspnoea' is associated with advanced disease. 'Mental status change' points to a CNS complication. 'Constipation' is not typical.
Based on this analysis, conclude that marked weight loss is the most fitting answer for a 'common' symptom among the choices provided.

Concept Tested & Keywords

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E6 Medicine Harrison 22e Part 1 pp. 1428-1430, 1430-1432

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

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Attempt every question from this paper in a timed mock, then review the full solution for each one.