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Medicine

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Respiratory

Question
11 out of 20
 

All of the following statements about Miliary Tuberculosis are true Except: (PGI May 2010)



A May occur following primary infection

B May occur following secondary reactivation

C Sputum microscopy is usually negative

D Mantoux is always positive

E Liver, kidney and spleen are common sites of involvement

Ans. D

Mantoux is always positive

Miliary tuberculosis


1). This is produced by acute dissemination of bacilli via blood resulting in the appearance of discrete nodular shadows of size 2mm..

2). Choroid tubercles on fundus examination in children.

3). Sputum negative in 80% of cases.

4). Anemia, leukopenia may be there.


Extra Edge:

1). Miliary TB may occur following primary infection and secondary reactivation

2). Sputum microscopy is usually negative

3). Mantoux test is negative in 20-30% of patients with Miliary TB

4). Liver, kidney and spleen are common sites of involvement along with other sites.

Cryptic miliary tuberculosis

1). Seen in elderly, chronic course.

2). No choroid tubercles.

3). Tuberculin test negative. CXR normal (size of tubercles <0.5mm)

Non – reactive miliary tuberculosis

i. Acute septicemic form.

ii. Pancytopenia.

iii. Rapidly fatal.

iv. Multiple necrotic non – granulomatous, (non – reactive) lesions.

Extra Edge:

Pulmonary tuberculosis is known to leave behind a lot of devastations even after complete biological cure of the disease.

These may be classified as

1). Parenchymal; tuberculoma, cavity, aspergilloma and carcinoma.

2). Airway lesions; broncholithiasis, bronchial stenosis and bronchiectasis.

3). Vascular; pulmonary and bronchial arteritis, and Rasmussen's aneurysm.

4). Mediastinal; lymph node calcification, esophagobronchial and mediastinal fistulae, fibrosing mediastinitis and constrictive pericarditis.

5). Pleural; chronic empyema, fibrothorax, bronchopleural fistula and pneumothorax.

6). Chest wall lesions. Rasmussen's Aneurysm is a very rare sequelae of Pulmonary Tuberculosis

Respiratory Flashcard List

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