This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: recent papers  obst, Subject name: Gynaecology & Obstetrics
[{'content': 'Gonococcus affects tubes mainly by _________ \nSelect and explain. \nA. Hematogeous spread, B. Lymphatic spread, C. Parametrium spread, D. None of the above', 'role': 'user'}, {'content': 'Answer: D \nExplanation: Gonococcus ascends up to the tube mainly mucosal continuity and contiguity, which is facilitated by sexually transmitted vectors such as sperms and Trichomonas. The mucous membrane is first affected and it is edematous, infiltrated with leucocytes and plasma cells. Another route is through reflux of mucosal blood. Mycoplasma spreads across parametrium Lymphatics are involved in spread of secondary organisms and PID following post-aboal and pueperal infection. Organisms from gut affect tubes directly. Ref: Shaw&;s textbook of Gynaecology 17th edition Pgno: 339', 'role': 'assistant'}]