L1 Question 1:
What is the primary mode of transmission of Mycobacterium tuberculosis?
A) Ingestion of contaminated food
B) Inhalation of aerosolized droplets
C) Contact with infected skin lesions
D) Hematogenous spread
Answer: B) Inhalation of aerosolized droplets
Comment: Tuberculosis primarily spreads through inhalation of infected aerosolized droplets, which deposit in the alveoli, leading to primary infection.
Reference: Sharma SK, Mohan A. “Extrapulmonary tuberculosis: A review article.” Indian J Med Res. 2004;120(4):316-353.
L1 Question 2:
Which organ is most commonly affected in disseminated TB?
A) Brain
B) Liver
C) Lungs
D) Kidneys
Answer: C) Lungs
Comment: The lungs are the primary site for Mycobacterium tuberculosis infection due to the airborne transmission of the pathogen.
Reference: Burrill J, Williams C, Bain G, et al. “Tuberculosis: A Radiologic Review.” Radiographics. 2007;27(5):1255-1273.
L1 Question 3:
What imaging feature is commonly seen in miliary tuberculosis on a chest X-ray?
A) Consolidation in a single lobe
B) Small nodules scattered throughout both lungs
C) Pleural effusion without parenchymal changes
D) Cavitation in the lower lobes
Answer: B) Small nodules scattered throughout both lungs
Comment: Miliary TB is characterized by numerous tiny nodules distributed diffusely throughout the lungs due to hematogenous spread.
Reference: Burrill J, Williams C, Bain G, et al. Radiographics. 2007;27(5):1255-1273.
L1 Question 4:
Which of the following histological features is most characteristic of disseminated TB?
A) Lymphocytic infiltration
B) Caseating granulomas
C) Giant cell tumors
D) Eosinophilic infiltration
Answer: B) Caseating granulomas
Comment: Disseminated TB is characterized by the formation of caseating granulomas with central necrosis, which is typical of Mycobacterium tuberculosis infection.
Reference: Sharma SK, Mohan A. Indian J Med Res. 2004;120(4):316-353.
L1 Question 5:
Which test is most commonly used to confirm a diagnosis of disseminated TB?
A) Sputum culture for M. tuberculosis
B) Urinalysis
C) Blood cultures
D) Stool examination
Answer: A) Sputum culture for M. tuberculosis
Comment: Sputum culture and acid-fast bacilli (AFB) testing remain the standard for confirming active TB infection, even in disseminated cases.
Reference: Sharma SK, Mohan A. Indian J Med Res. 2004;120(4):316-353.
L2 Question 6:
Which of the following statements regarding the spread of disseminated TB is true?
A) It occurs exclusively through hematogenous spread.
B) It can involve both hematogenous and direct transperitoneal spread.
C) It involves only lymphatic spread.
D) It only occurs in the lungs.
Answer: B) It can involve both hematogenous and direct transperitoneal spread.
Comment: Disseminated TB can spread via hematogenous, lymphatic, and transperitoneal routes, especially in immunocompromised patients.
Reference: Burrill J, Williams C, Bain G, et al. Radiographics. 2007;27(5):1255-1273.
L2 Question 7:
In a patient with suspected disseminated TB and splenic nodules, which imaging technique can confirm functional splenic tissue?
A) MRI
B) Tc-99m sulfur colloid scan
C) PET-CT
D) KUB
Answer: B) Tc-99m sulfur colloid scan
Comment: Tc-99m sulfur colloid scan can confirm functional splenic tissue in cases of splenosis or granulomatous diseases.
Reference: Bhatt M, Maturu V, Singh S et al. Nucl Med Commun. 2018;39(7):643-649.
L2 Question 8:
Which imaging finding is most suggestive of peritoneal tuberculosis?
A) Fat stranding around the mesentery
B) Omental caking with thickened peritoneum
C) Isolated hepatomegaly
D) Enlarged retroperitoneal lymph nodes
Answer: B) Omental caking with thickened peritoneum
Comment: Peritoneal TB often presents with omental caking, peritoneal thickening, and ascites on CT imaging.
Reference: Burrill J, Williams C, Bain G, et al. Radiographics. 2007;27(5):1255-1273.
L2 Question 9:
Which of the following conditions can present similarly to peritoneal tuberculosis on imaging?
A) Peritoneal carcinomatosis
B) Hepatic hemangioma
C) Crohn’s disease
D) Primary sclerosing cholangitis
Answer: A) Peritoneal carcinomatosis
Comment: Peritoneal TB and peritoneal carcinomatosis both present with omental caking, peritoneal thickening, and ascites, requiring biopsy for definitive diagnosis.
Reference: Burrill J, Williams C, Bain G, et al. Radiographics. 2007;27(5):1255-1273.
L2 Question 10:
Which of the following is a recommended treatment for disseminated TB?
A) Isoniazid, Rifampin, Pyrazinamide, and Ethambutol
B) Ciprofloxacin monotherapy
C) Steroids alone
D) Amphotericin B
Answer: A) Isoniazid, Rifampin, Pyrazinamide, and Ethambutol
Comment: The standard regimen for disseminated TB includes four-drug therapy with isoniazid, rifampin, pyrazinamide, and ethambutol for at least 6 months.
Reference: Sharma SK, Mohan A. Indian J Med Res. 2004;120(4):316-353.