Discuss the steps in Sue’s physical exam. What lab work would you order? What additional tests would you order? What diagnosis do you suspect? What treatment would you prescribe? I believe she possibly has TB

Your patient (Sue) is a registered nurse, 48 years of age, who has worked for 20 years in a large medical center in California. The hospital is located in an area with a large population of immigrants many from Southeast Asia. The last few years have been rough for her family. Her mother recently died from a long battle with breast cancer and her husband has been unemployed for almost two years. Sue has been trying to help her father cope with her mother’s death and at the same time has been working a lot of overtime to pay the bills. She has not had time to personally grieve the loss of her mother and tells you she is having a lot of sleepless nights. In January, Sue came down with bronchitis that has never resolved. She finds herself either coughing all night long or drenched in sweat. She wonders if she has the flu and can’t seem to shake it since she is so run down. She has come to you for a physical exam to help understand what is going on and how to fix it. Discuss the steps in Sue’s physical exam. What lab work would you order? What additional tests would you order? What diagnosis do you suspect? What treatment would you prescribe? I believe she possibly has TB