Self-Assessment Questions (SAQs) for Study Session 14

Now that you have completed this study session, you can assess how well you have achieved its Learning Outcomes by answering these questions. Write your answers in your Study Diary and discuss them with your Tutor at the next Study Support Meeting. You can check your answers with the Notes on the Self-Assessment Questions at the end of this Module.

SAQ 14.1 (tests Learning Outcome 14.1)

What are the phases of anti-TB treatment and how do they differ from each other?

Answer

There are two phases in TB treatment: the intensive phase and the continuation phase. During the intensive phase the patient took anti-TB drugs in front of you, or another health professional, or another treatment supporter. While in the continuation phase, the patient collects their medication monthly and you check that timely collection and adherence to treatment is occurring.

SAQ 14.2 (tests Learning Outcomes 14.1 and 14.2)

A 54-year-old farmer came to the health centre complaining of a cough that had lasted for over three weeks and produced whitish sputum. He also complained of low grade fever, drenching night sweat, marked loss of weight and decreased appetite.

  • a.How would you classify this farmer, and what would you do for him?
  • b.What additional test would you advise?

Answer

  • a.This patient has symptoms of TB and is therefore a TB suspect and in need of investigation for TB. So you should refer this patient for sputum smear examination to a TB treatment facility.
  • b.This patient also needs counselling for HIV testing, since there is significant overlap between these two diseases and HIV is one of the major risk factors for a patient to develop TB disease.

SAQ 14.3 (tests Learning Outcomes 14.1, 14.3 and 14.4)

W/r Almaz had experienced a cough with bloody sputum for one month; she was seen at a health centre and sputum examination showed positive for TB bacteria. She had no previous history of TB treatment.

  • a.How do you classify W/r Almaz based on the smear result?
  • b.Which type of patient is she (new, relapse, treatment failure, etc)?
  • c.What category of treatment is needed for this patient and what is the correct treatment regimen?

Answer

  • a.W/r Almaz should be classified as ‘smear-positive pulmonary tuberculosis’.
  • b.This patient is categorised as ‘new’ since there is no previous treatment for TB.
  • c.This patient is put under ‘Category I’ and treated with the following regimen:
  • Initial phase 2 (HRZE/S)
  • Continuation phase 4 (HR) or 6 (HE).

SAQ 14.4 (tests Learning Outcome 14.5)

A 34-year-old female was diagnosed by sputum examination to have pulmonary TB and started on anti-TB drugs two weeks ago. She noticed reddish discoloration of her urine, but has had no other symptoms for one week. She was worried and came to you.

  • a.What do you think is the most likely cause of discoloration of the urine in this patient?
  • b.What advice would you give her?

Answer

  • a.The most likely cause in this patient is related to rifampicin, since this drug can cause reddish discoloration of urine.
  • b.Reassure the patient that this causes no harm; the patient should be advised to continue her medication.

Summary of Study Session 14