skip to main content

Disseminated tuberculosis — SCE Respiratory MCQ

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

HardTuberculosis and NTMDisseminated tuberculosisSCE Respiratory

A 34-year-old woman with HIV presents with fever, cough and diffuse micronodules on chest radiograph. CD4 count is 36 cells/µL and blood cultures later grow Mycobacterium tuberculosis complex. She has hepatosplenomegaly and pancytopenia. Sputum smear is negative. What is the most likely diagnosis?

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

Reveal the answer and explanation

Correct answer: E — Disseminated tuberculosis

The best answer is “Disseminated tuberculosis”. The clinical pattern, physiology and imaging described are most consistent with Disseminated tuberculosis. The competing diagnoses may share individual findings, but do not account for the complete combination in the stem. The remaining choices—“Pulmonary sarcoidosis, after safety review”, “Community-acquired pneumococcal pneumonia”, “Simple latent TB infection”, “Aspergilloma, within a respiratory pathway”—are credible in related respiratory presentations, but each addresses a different diagnostic, staging or management decision and does not fit the decisive findings and pathway position in this stem.

Reference: British Thoracic Society pulmonary nodule guideline: https://thorax.bmj.com/content/70/Suppl_2/ii1