RESPIRATORY
RESPIRATORY
Embedded Files
TUBERCULOSIS
TUBERCULOSIS
Introduction
5 minIntroduction
Introduce yourself and the group
Provide rationale for the session and relevance to clinical practice
Outline learning objectives:
- Recognise common risk factors for tuberculosis infection
- Recognise presenting features of tuberculosis infection and suggest key differential diagnoses
- Understand local infection control policy for patients with suspected tuberculosis infection and national reporting procedures
- Understand the role of common investigations in diagnosis of tuberculosis
- Understand the initial management of a patient with tuberculosis
Explain structure of session
Total time:
60 minNumber of students:
1-5Grade of students:
3rd to 5th year medical studentsCreated by:
Dr Charlotte HaydenUploaded:
10th February 2020Last updated:
10th February 2020Resources needed for this session:
Resources needed for this session:
Pen, paper, whiteboard or flipchart paper if possible
Students can scan the QR code opposite to view all investigation results on their phone as you work through the session.
Resources linked to this session:
Resources linked to this session:
None
Activity 1: Clinical Presentation and Risk Factors
5 minActivity 1: Clinical Presentation and Risk Factors
Before seeing a patient, encourage students to identify common risk factors for developing tuberculosis. Reiterate the importance of asking a thorough social history, including housing, travel history, migration status, possible infected contacts, history or risk factors for HIV etc.
Discuss the key presenting features of tuberculosis.
Activity 2: History Taking and Clinical Examination
25 minActivity 2: History Taking and Clinical Examination
Ask the student(s) to take a focused history from a patient with suspected or confirmed tuberculosis. Pay close attention to any necessary infection control precautions. Encourage students to ask about the risk factors mentioned above and perform a focused respiratory examination. This could be observed if capacity of the tutor allows.
If there is no patient available, this could be adapted into a discussion task, using patient notes, or a hypothetical patient as a basis for discussion.
Activity 3: Case-Based Discussion
5 minActivity 3: Case-Based Discussion
Encourage the student(s) to present the key findings of the case (maximum 1 minute). Brief feedback on history, examination and presentation style.
Discussion points:
- What differential diagnoses have you considered and why are these less likely?
- What initial investigations would be useful and what are you expecting them to show?
Activity 4: Basic Radiology Interpretation
5 minActivity 4: Basic Radiology Interpretation
Allow the student(s) to review the patient’s chest x-ray. If none is available, use the example opposite.
Ask them to identify and describe the key abnormality.
Discuss:
- What further tests would be helpful in diagnosing tuberculosis?
- What management is indicated for confirmed cases of tuberculosis?
- What are the key side effects and how do we monitor for these?
Activity 5: Further Management
10 minActivity 5: Further Management
Ask the student(s) to find the local infection control guidelines for management of patients with suspected tuberculosis and to consider how these apply to the patient they have seen.
Discuss Public Health England reporting procedures:
- Why are these important?
- What does PHE do with the information once a case is reported?
- What other disease are 'notifiable'?
Summary and Feedback
5 minSummary and Feedback
Questions
Identify and summarise key learning points (key three points if possible)
Feedback to student – highlight further learning needs
Feedback for teacher - ask students to provide feedback using the QR code opposite
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