Which scenario raises suspicion for TB?

• A. A patient with a persistent cough and recent exposure to TB
• B. A patient with a sprained ankle
• C. A patient with dehydration from heat
• D. A patient with allergic rhinitis

Answer: (A)

The situation tests recognition of when a contagious respiratory infection might be present. A persistent cough together with recent exposure to tuberculosis raises concern for active TB because TB typically causes a cough that lasts weeks and exposure to someone with TB increases the likelihood that infection could be present. This combination means you should think about TB and follow appropriate infection-control steps (such as using airborne precautions and arranging prompt medical evaluation for testing and imaging).

The other scenarios don’t fit TB as clearly. A sprained ankle centers on musculoskeletal injury with pain and swelling. Dehydration from heat is a volume and electrolyte problem, not an infectious respiratory illness. Allergic rhinitis causes sneezing, itching, and nasal congestion and does not indicate active pulmonary TB.