skip to main content

Miliary tuberculosis — SCE Respiratory MCQ

Instant feedback + full explanation. One question, done properly.

HardTB and NTMMiliary tuberculosisSCE Respiratory

A 25-year-old man returns from South Asia with 3 weeks of fever, cough and weight loss. CXR shows miliary nodules throughout both lungs. He is confused and sodium is 126 mmol/L. HIV test is negative. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Urgent anti-tuberculous therapy and assessment for disseminated/CNS TB

Miliary nodules with systemic symptoms after travel to a high-incidence area suggest disseminated TB; confusion and hyponatraemia raise concern for CNS or adrenal involvement, requiring urgent treatment and assessment. Short-course standard pneumonia therapy is inadequate. Reassurance or asthma treatment would be unsafe.

Reference: NICE NG33 Tuberculosis; UKHSA TB guidance