The route of Mantoux skin test is:

Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)

Nursing Foundation

Easy

Appeared in: Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)

Explanation

The Mantoux test requires injecting tuberculin purified protein derivative (PPD) into the dermis, the layer just below the epidermis.
The intradermal route is essential because it has the slowest absorption rate, which allows a localized immune reaction (induration) to form.
This localized reaction is visible and measurable, enabling accurate interpretation of the test result for tuberculosis exposure.
A correctly administered intradermal injection creates a distinct, pale, raised area called a 'bleb' or 'wheal'.

Option A: The intramuscular route has a much faster absorption rate due to the muscle's rich blood supply. This would prevent the localized reaction needed for the Mantoux test.
Option B: The intravenous route provides immediate systemic distribution. Injecting tuberculin this way would be dangerous, potentially causing a systemic allergic reaction, and would not produce a readable skin test.
Option D: The subcutaneous route involves injection into the fatty tissue below the skin. Absorption is faster than intradermal, which would make the test result unreliable and difficult to interpret accurately.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Administration route for Mantoux (tuberculin) skin test as background academic context rather than a clinical decision trigger.
A nurse's primary role includes correctly administering the Mantoux test using the intradermal technique, typically on the inner forearm.
Accurate technique is critical. If the injection is too deep (subcutaneous), no bleb will form, and the test result will be invalid, requiring a re-test.
Patient education is key. The nurse must instruct the patient not to scratch or cover the site and to return in 48-72 hours for the reading.

How to Approach the Question

First, identify the core of the question, which is asking for the specific administration route for the 'Mantoux skin test'.
Recall or deduce the purpose of the Mantoux test. It's a diagnostic skin test that relies on a localized reaction.
Consider the properties of the different injection routes provided in the options (Intramuscular, Intravenous, Intradermal, Subcutaneous).
Evaluate which route would best facilitate a slow, localized reaction that can be observed on the skin. The term 'dermal' in 'Intradermal' is a strong clue, as it relates to the skin (dermis).
The intradermal route is specifically designed for skin tests due to its slow absorption, making it the correct choice.
Eliminate the other options: IV is too fast and systemic, IM is too fast, and SC is faster than ID and less reliable for this type of test.

Concept Tested & Keywords

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E6 Anatomy Applied Ashalatha 4e p. 232-234

E6 Pharmacology Nursing Lilley 11e Part 1 p. 41-43