• Card 10 / 14: J.K., diagnosed with rheumatoid arthritis of 2 years was referred to your clinic. She constantly complains of joint pains in spite of good compliance to medications. Her attending rheumatologist is requesting for an infectious disease clearance to start infliximab. What would be your next step?
    A) Give the clearance; infliximab does not increase the risk for any infection
    B) Grant the clearance once a baseline chest radiograph is devoid of infiltrates
    C) Will do both IGRA test and chest radiograph; if both are positive, will initiate anti-TB treatment and advise against infliximab
    D) Will do both IGRA test and chest radiograph; if only the IGRA test is positive, will advise to complete isoniazid prophylaxis before starting infliximab

    Answer:
    C) Will do both IGRA test and chest radiograph; if both are positive, will initiate anti-TB treatment and advise against infliximab

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Clinical Issues in TB Management

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