A patient with hemoptysis, night sweats, and fatigue who is feverish is suspected of having which condition?

• A. Tuberculosis
• B. Pneumonia
• C. Lung cancer
• D. Bronchitis

Answer: (A)

The main idea is that tuberculosis often presents with systemic symptoms like night sweats, fever, and fatigue, along with the potential for coughing up blood. The night sweats and fever reflect a chronic infectious process, while hemoptysis can occur when tuberculous inflammation causes cavitation in the lungs and erosion into airways. Reactivation TB frequently involves the upper lobes, where oxygen tension is higher, predisposing to cavitation and bleeding.

Pneumonia typically shows an acute onset of fever with a productive cough and focal findings on exam or imaging, but night sweats and hemoptysis are less characteristic. Lung cancer can cause hemoptysis and weight loss, but fever and night sweats are not as typical unless there is a paraneoplastic or infectious complication. Bronchitis mainly presents with cough and sputum production, sometimes mild fever, but systemic night sweats and significant hemoptysis are not defining features.

So the combination of hemoptysis, night sweats, fatigue, and fever fits tuberculosis best.