Tuberculosis (pulmonary) Quiz: Ace Your Exams

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A 31-year-old woman presents to the clinic with a 2-month history of a productive cough, low-grade fever, night sweats, fatigue, and unintentional weight loss of 3.6 kg (8 lbs). Past medical history is unremarkable. The patient recently immigrated from the middle east to the United States. Her temperature is 37.9°C (100.2°F), blood pressure is 118/69 mmHg, pulse is 80/min, respiratory rate is 18/min, and oxygen saturation is 96% on room air. Physical examination is significant for rhonchi in her left upper lung field. Chest radiography shows a left upper lobe cavitary lesion with consolidations and ipsilateral hilar lymphadenopathy. Which of the following is the best initial next step in the evaluation?  

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