A 55-year-old immunocompetent man presents with hemoptysis, weight loss, and apical fibronodular opacities on CXR. Sputum AFB smear is positive. In post-primary (reactivation) pulmonary tuberculosis, the lesions have a predilection for which anatomical site?

• A Lower lobe, basal segments
• B Middle lobe and lingula
• C Apical and posterior segments of upper lobes ✓
• D Anterior segments of upper lobes

Explanation

Post-primary (reactivation) TB classically localizes to the apical and posterior segments of the upper lobes due to the higher oxygen tension in these regions, which favors mycobacterial growth. The Ghon complex (primary TB) occurs in the middle or lower zones. This apical predilection is a high-yield concept for NEET PG and INI-CET.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.