This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Tuberculosis of the Genital Tract, Subject name: Gynaecology & Obstetrics
Most common route of dissemination from primary site causing tuberculosis of uterus is - 
Select and explain. 
A. Lymphatic spread, B. Transcoelemic spread, C. Hematogenous spread, D. Direct contact
C: Hematogenous spread
Answer: C: Hematogenous spread 
Explanation: Ans. is 'c' i.e., Hematogenous spread Pathogenesis of genital tuberculosiso The causative agent is commonly M. tuberculosis (95%), but in a few cases it is caused by the Mycobacterium bovis (5%), particularly in underdeveloped countries where effective tuberculosis control programmes for cattle are not in place and pasteurization of milk not routinely practiced. These organisms are identified on routine staining of infected ma- terial with Ziehl-Neelsen's acid-fast staino Genital tuberculosis occurs almost always secondary to a primary focus elsewhere, the commonest site being the lungs (50%), but rarely from other sites such as lymph nodes (40%), the kidneys, joints, gastrointestinal tract or as part of a generalized miliary infection.o The mode of spread is generally haematogenous or via lymphatics, and rarely from direct contiguity with an intraabdominal organ or affected peritoneum.