Public Health: Storyboard
John Cardinal, Linda Lambert’s nephew, is living with the Lambert
while going to university. He is from a First Nation’s Reservation
in another province. In the second semester of his first year
there, John develops an acute illness with a cough and fever. He
sees a family physician, Dr. Gold, at the university’s health
services and is diagnosed with a viral upper respiratory tract
infection.
John returns to see Dr. Gold when his cough persists for over two
weeks and he develops some unilateral chest pain. On examining
John’s chest, Dr. Gold hears a rub and orders a chest x-ray.
John goes to a community DI clinic and gets his chest x-ray done.
The radiologist there reviews the image later that day and creates
a report of the findings. He notes a small pleural effusion.
The next day, Dr. Gold reviews the DI image along with the
radiologist’s report of it and has his office staff call John back
in.
John returns to Dr. Gold’s office and is told the findings. John
reports he has developed some blood in his sputum. Dr. Gold is
suspicious of TB so he performs a Mantoux test and orders sputum
cultures.
John returns two days later for interpretation of the Mantoux test.
He has already been able to provide three sputum samples that he
delivered to the nearest community lab. Dr. Gold determines the
Mantoux test is positive and reviews John’s health profile but sees
no record of BCG immunization or TB infection. Dr. Gold decides to
treat this is an active TB infection. He prescribes John the
appropriate medications and completes the Active Tuberculosis
Report Form.
The next day Dr. Gold receives a lab report indicating the sputum
is positive for acid-fast bacilli and the culture is pending.
Public health officials act on the report form and commence contact
investigation and case management.
Encounters
- 10.1.1 TB First Assessment
- 10.1.2 TB Diagnosis
