TB Test

TB History

Have you ever had a positive TB skin test? Yes
No
Don't Know
Have you ever had an abnormal chest x-ray? Yes
No
Don't Know If yes, how long ago?
Have you recently had the mucous you cough up tested for TB? Yes
No
Don't Know If yes, were you told it was positive? Yes
No
Don't Know
Have you ever been told you have Infectious Tuberculosis? Yes
No
Don't Know If yes, how long ago?
Have you ever been treated with medication for Infectious TB? Yes
No
Don't Know If yes, how many medications? One
Two
Over Two
Are you still taking TB medicine? Yes
No
Did you take all the TB medicine until the health care professionals told you that you were finished? Yes
No
Do you live with or have you been in close contact with someone who was recently diagnosed with TB? (E.g. shelter roomate, close friend, relative). Yes
No
Don't Know

Current Symptoms

Do you have a cough that has lasted longer than three weeks? Yes
No
Do you cough up blood or mucous? Yes
No
Have you lost your appetite? Aren't hungry? Yes
No
Have you lost weight (more than 10 pounds) in the last two months, without trying to? Yes
No
Do you have night sweats (need to change the sheets or your clothes because they are wet)? Yes
No