MRCP UK EXAMINATIONS

RESPIRATORY

OLD TUBERCULOSIS

Question [CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
According to the COTS consensus, which choroidal manifestation/s require only a positive immunologic test (IGRA or TST) to suggest starting anti-TB therapy?
A
Tuberculoma
B
Focal choroiditis
C
Multifocal choroiditis
D
Serpiginous-like choroiditis
Explanation: 

Detailed explanation-1: -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-2: -The most common ocular TB manifestation is granulomatous uveitis. The most common presentation is posterior uveitis. The most typical lesions related to ocular TB are choroidal granulomas, occlusive retinal vasculitis, and multifocal serpiginous-like choroiditis.

Detailed explanation-3: -Choroidal tuberculoma is a rare ocular form of tuberculosis (TB) that raises both a diagnostic and a therapeutical challenge, especially when occurring without other manifestations of the disease. This study reports the case of a 27-year-old woman who had a unilateral drop of vision (20/100) with ocular pain.

Detailed explanation-4: -Clinical diagnosis The diagnosis of tuberculosis uveitis requires a combination of patient history, clinical examination and adjunct testing. Demonstration of AFB by microscope or culture of M. tuberculosis from the ocular fluids. Positive polymerase chain reaction from ocular fluids.

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