Genital tuberculosis occurs mainly in women in the following organ?

Appeared in: BCCL kharkhanda Staff Nurse - 2015

Explanation

Genital tuberculosis in females most commonly affects the fallopian tubes, with involvement in 90-100% of cases.
The infection typically arises from hematogenous (bloodstream) spread from a primary infection site, such as the lungs.
The fallopian tubes' rich vascularity makes them the most frequent initial site for tubercle bacilli to settle and multiply in the genital tract.
This primary involvement of the tubes is the main reason genital TB is a significant cause of female infertility, as it leads to tubal blockage and damage.

Option B: The uterus (specifically the endometrium) is the second most commonly affected organ, not the primary one. It is involved in about 50-60% of cases, usually secondary to infection in the fallopian tubes.
Option C: The cervix is affected much less frequently, with an incidence of only 5-15%. It is not the main site of infection.
Option D: Tuberculosis of the vagina is extremely rare, occurring in less than 1% of genital TB cases. It is the least likely organ in the female genital tract to be affected.

Clinical Relevance

Nursing practice connection: Knowing Primary site of female genital tuberculosis helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
A key nursing responsibility is to maintain a high index of suspicion for genital TB in female patients presenting with infertility, menstrual irregularities (like amenorrhea or dysmenorrhea), and chronic lower abdominal pain, especially if they have a history of TB or come from an endemic area.
Early diagnosis and initiation of anti-tubercular therapy (ATT) are crucial. Nurses play a vital role in patient education regarding treatment adherence to prevent drug resistance and potentially preserve fertility.
What if? If a patient with known pulmonary TB develops new-onset amenorrhea and pelvic pain, the nurse should immediately consider the possibility of genital TB and facilitate a gynecological consultation for further evaluation, including endometrial biopsy or laparoscopy.

How to Approach the Question

First, identify the core of the question, which asks for the 'main' or most common organ affected by genital tuberculosis in women.
This is a factual recall question based on the pathophysiology of the disease.
Recall that genital TB is usually a secondary infection spread via the bloodstream.
Consider the anatomy and blood supply of the female reproductive organs. The fallopian tubes have a rich blood supply, making them a common site for hematogenous spread.
Evaluate the options based on the known frequency of involvement: Fallopian tubes are most common, followed by the endometrium (uterus), then ovaries, and rarely the cervix or vagina.
Select the option that represents the most frequently affected organ.

Concept Tested & Keywords

Q4JcfijZEBkRO_pOHzM0oi

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1849-1851

E6 Microbiology Essentials Sastry 4e Part 2 p. 155-157

E6 Gynecology Williams p. 19-45

Practise the full BCCL kharkhanda Staff Nurse - 2015

Attempt every question from this paper in a timed mock, then review the full solution for each one.