A 28-year-old woman complains of chest pain for 1.5 months. Three months prior to the current visit, she developed cough with expectoration, worse in the early morning. There was no shoness of breath or hemoptysis About 2 months after the onset of the cough, she began to have intermittent pleuritic (worse with coughing or deep breathing) left sided chest pain, increasing fatigue and weight loss of 3kgs but no loss of appetite. On auscultation: fine crackles in the suprascapular areas bilaterally were present(L>>R). The left upper lobe was dull to percussion. All are contents of the classic medium used for the above disease except: –

Correct Answer: L-glutamine
Description: The patient comes with a constellation of weight loss, productive cough, and cavitary pulmonary infiltrates, which is extremely characteristic of TB. The medium being asked is the Lowenstein-Jensen medium, an egg-based solid medium that suppos the growth of Mycobacterium species, including Mycobacterium tuberculosis. CXR shows well defined cavitary lesions in left upper lung zone and right lower lung zone. COMPOSITION OFLJ MEDIUM Ingredients Potato Flour (Potato Starch) L-Asparagine Monopotassium Phosphate Magnesium Citrate Malachite Green Magnesium Sulfate Glycerol Egg suspension Distilled Water
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