1. Symptoms
   1. palpable tender Rt. cervical lymph node
   2. chest percussion
      1. stony dullness on Rt. side
      2. pleural effusion
   3. Auscultation
      1. crackles in Rt. apex
      2. decreased breath sounds on Rt. base
   4. chest X-ray showed TB changes
2. Plan
   1. Management
      1. Antimycobacterial drug
         1. 1st line agents:
            1. Isoniazid
            2. Rifampin
            3. Ethambutol
            4. Pyrazinamide
            5. Streptomycin
         2. 2nd line agents:
            1. Aminosalicylic acid
            2. Ethionamide
            3. Cycloserine
         3. Surgically evacuated
   2. Prognosis
      1. Symptoms often improve in 2 to 3 weeks after starting treatment.
3. Assessment
   1. History taking
   2. P/E
   3. Microbiological Culture
   4. Tuberculin Skin Test
   5. Interferon–Gamma Release Assays (IGRAs)
   6. PCR and Probes
   7. Imaging
      1. X-ray
      2. CT scan
      3. MRI
4. Signs
   1. cough with sputum
   2. low-grade fever
   3. generalized weakness
   4. fatigue
   5. night sweats
   6. breathlessness
5. Demographics
   1. Male
   2. 55 yrs old
   3. pwns a poultry processing plan
   4. no travel history
   5. smokes pack/day