USMLE PRACTICE QUESTION OF THE WEEK

Question for October 03, 2025

A 34-year-old man presents with 3 weeks of cough, fever, night sweats, and weight loss. He recently moved to the United States from Vietnam, where he worked in construction. He denies hemoptysis but reports poor appetite and fatigue. He lives in an apartment with 3 other men. He has no known medical conditions. Temperature is 38.3°C (100.9°F), pulse 102/min, respirations 20/min. BMI is 18.5 kg/m². On exam, he appears thin and tired. Auscultation reveals crackles over the right upper lung field. Chest radiograph shows a cavitary lesion in the right upper lobe. The results of the sputum smears for acid-fast bacilli are pending.

Which of the following infection control measures should be implemented immediately?

A. Contact precautions

B. Droplet precautions

C. Standard precautions

D. Airborne precautions with negative-pressure room

E. Reverse isolation

Get Detailed Explanation

Correct Answer:

D. Airborne precautions with negative-pressure room

Correct Answer Explanation:

This patient's subacute cough, weight loss, night sweats, and cavitary lesion are consistent with pulmonary tuberculosis. Patients suspected of TB require airborne isolation in a negative-pressure room until disease is excluded. Droplet precautions prevent spread of larger particles (eg, influenza). Contact precautions are for pathogens spread by touch (eg, MRSA). Reverse isolation is for immunocompromised patients.

Further Insight:

Airborne: TB, measles, varicella
Droplet: meningococcus, influenza
Contact: MRSA, C. difficile