MRCP UK EXAMINATIONS

RESPIRATORY

OLD TUBERCULOSIS

Question [CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
According to the COTS consensus, both radiologic (chest CT / xray) and immunologic tests (TST or IGRA) are suggested to be POSITIVE prior to starting ATT in the following phenotypes:
A
Recurrent anterior granulomatous uveitis
B
First episode anterior granulomatous uveitis
C
Panuveitis
D
Intermediate uveitis
Explanation: 

Detailed explanation-1: -Paradoxical reaction/worsening in TB Definition: A “paradoxical reaction” while on ATT may consist of clinical or radiological worsening of pre-existing TB lesions or the development of new lesions in patients who showed an initial response or improvement with treatment.

Detailed explanation-2: -In conclusion, serpiginous like choroiditis is a rare immune-mediated condition triggered by tuberculosis with deleterious complications for the eye. Early, aggressive treatment with multiple anti-TB antibiotics and multiple immunosuppressive agents can stop the evolution and preserve vision.

Detailed explanation-3: -Intraocular tuberculosis (TB) infection can have different clinical manifestations including retinal vasculitis. It more frequently involves the veins and is associated with retina haemorrhages and neovascularisation.

Detailed explanation-4: -INTRODUCTION. Old healed tuberculosis (TB) can be defined as radiographic lesions suggesting TB sequelae without clinical or microbiological evidence of active pulmonary TB.

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