**Question:** In Genitourinary TB, True is -

A. Directly observed therapy
B. Involvement of both kidneys
C. Presence of granulomas
D. Sexual transmission

**Core Concept:** Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis, which primarily affects the lungs (pulmonary TB), but can also involve other organs, including the genitourinary system.

**Why the Correct Answer is Right:** In genitourinary tuberculosis (GUTB), the true features include the presence of granulomas and involvement of both kidneys. Granulomas are characteristic non-necrotizing granulomatous lesions that form in response to the infection. Involvement of both kidneys is crucial as GUTB can cause significant morbidity and mortality if left untreated.

**Why Each Wrong Option is Incorrect:** Option A, Directly observed therapy, is relevant in managing TB but is not a feature of the disease itself. Option B, involvement of only one kidney, is incorrect as GUTB typically involves both kidneys. Option D, sexual transmission, is important for the mode of transmission but not a feature of the disease.

**Clinical Pearl:** GUTB is more common in immunocompromised patients, such as those with human immunodeficiency virus (HIV) coinfection. It is essential for medical students and practitioners to be aware of GUTB manifestations and differential diagnoses, which include other granulomatous diseases like sarcoidosis, lymphoma, and leprosy.

**Correct Answer: C. Presence of granulomas and involvement of both kidneys**

In genitourinary tuberculosis, the presence of granulomas and involvement of both kidneys are the true features that differentiate it from other granulomatous diseases, ensuring appropriate diagnosis and management.