>>>Part 8
53.1 First line antitubercular drugs include the following except:
A. Ciprofloxacin
B. Streptomycin
C. Pyrazinamide
D. Ethambutol
53.2 As an antitubercular drug, isoniazid has the following advantages except:
A. It is tuberculocidal
B. It acts on both extra and intracellular bacilli
C. Tubercle bacilli do not develop resistance against it
D. It is cheap
53.3 What is true of isonicotinic acid hydrazide (INH):
A. An active transport mechanism concentrates INH inside sensitive mycobacteria
B. Sensitive mycobacteria generate an active metabolite of INH through a catalaseperoxidase
enzyme
C. The most common mechanism of INH
resistance is mutation in the target gene
which encodes for a specific fatty acid
synthase enzyme
D. Both 'A' and 'B' are correct
53.4 A patient of pulmonary tuberculosis treated with
rifampin + isoniazid + pyrazinamide developed parasthesias,
weakness, dizziness, ataxia and depressed
tendon reflexes. Which of the following
measures would you recommend:
A. Temporarily discontinue isoniazid and add pyridoxine
B. Substitute isoniazid with thiacetazone
C. Substitute pyrazinamide with ethambutol
D. Substitute rifampin with streptomycin
53.5 Which of the following antitubercular drugs is not
hepatotoxic:
A. Isoniazid
B. Rifampicin
C. Pyrazinamide
D. Ethambutol
53.6 The intermittently multiplying (spurter) tubercle bacilli
present within caseous material having low oxygen
tension are most susceptible to:
A. Ethambutol
B. Rifampin
C. Streptomycin
D. Pyrazinamide
53.7 Choose the correct statement about rifampin:
A. It is the most active drug on slow growing tubercle bacilli
B. Its antitubercular efficacy is lower than that of isoniazid
C. It is active against many atypical mycobacteria
D. It does not effectively cross blood-CSF barrier
53.8 Rifampin kills tubercle bacilli by:
A. Binding to mycobacterial DNA dependent RNA polymerase
B. Inhibiting mycobacterial DNA synthesis
C. Inhibiting synthesis of mycolic acids in mycobacteria
D. Damaging mycobacterial mitochondria
53.9 Occurrence of the following adverse reaction absolutely
contraindicates further use of rifampin in the
treatment of tuberculosis:
A. Respiratory syndrome
B. Cutaneous syndrome
C. Flu syndrome
D. Abdominal syndrome
53.10 Apart from its use in tuberculosis and leprosy, rifampin
is a first line drug for the following infective disease:
A. Toxoplasmosis
B. Brucellosis
C. Donovanosis
D. Leishmaniasis
53.11 Which first line antitubercular drug is only tuberculostatic
and not tuberculocidal:
A. Rifampin
B. Isoniazid
C. Ethambutol
D. Pyrazinamide
53.12 Ethambutol is not used in children below 6 years of age because:
A. Young children are intolerant to ethambutol
B. Ethambutol causes growth retardation in young children
C. It is difficult to detect ethambutol induced visual impairment in young children
D. In young children visual toxicity of ethambutol is irreversible
53.13 In a patient of pulmonary tuberculosis, pyrazinamide
is most active on the following subpopulation of tubercle bacilli:
A. Rapidly multiplying bacilli located on cavity walls
B. Slow growing bacilli within macrophages and at sites showing inflammatory response
C. Intermittently multiplying bacilli within caseous material
D. Dormant bacilli
53.14 The characteristic toxicity of ethambutol is:
A. Hepatitis
B. Visual defects
C. Vestibular disturbance
D. Renal damage
53.15 The antitubercular action of thiacetazone has the following feature(s):
A. It is a low efficacy antitubercular drug
B. It is combined with isoniazid to improve anti-tubercular efficacy of the latter
C. It is combined with isoniazid to prevent development of resistant infection
D. Both ‘A’ and ‘C’ are correct
53.16 Paraaminosalicylic acid is a second line antitubercular drug because of the following feature(s):
A. Low antitubercular efficacy
B. Frequent side effects
C. Bulky daily dose
D. All of the above
53.17 The primary reason for not using ethionamide as a
first line antitubercular drug is:
A. It produces gastrointestinal intolerance and hepatitis
B. It is only tuberculostatic and not tuberculocidal
C. Ethionamide resistance has become widespread
D. It has to be given by injection
53.18 Indicate the second line antitubercular drug that is
being preferred to supplement ethambutol + streptomycin
in case of hepatotoxicity due to isoniazid/
rifampin/pyrazinamide:
A. Ethionamide
B. Cycloserine
C. Ofloxacin
D. Capreomycin
53.19 Clarithromycin is used for the following:
A. Multidrug resistant M.tuberculosis infection
B. M.avium complex infection in AIDS patient
C. M.tuberculosis infection in a patient who
develops jaundice due to first line antitubercular drugs
D. Both ‘A’ and ‘B’ are correct
53.20 The most important reason for using a combination
of chemotherapeutic agents in the treatment of tuberculosis is:
A. To prevent development of resistance to the drugs
B. To obtain bactericidal effect
C. To broaden the spectrum of activity
D. To reduce adverse effects of the drugs
53.21 In the short course regimen for treatment of tuberculosis,
pyrazinamide and ethambutol are used for:
A. Initial one month
B. Initial two months
C. Last two months
D. Throughout the course
53.22 Addition of pyrazinamide and ethambutol for the first
two months to the isoniazid + rifampin therapy of
tuberculosis serves the following purpose(s):
A. Reduces the total duration of therapy to 6 months
B. Produces more rapid sputum conversion
C. Permits reduction of rifampin dose
D. Both ‘A’ and ‘B’ are correct
53.23 The short course chemotherapy of tuberculosis has
practically replaced the conventional regimens
because:
A. It is more efficatious
B. It is less toxic
C. It has yielded higher completion rates
D. All of the above are correct
53.24 What is true of DOTS strategy for treatment of tuberculosis:
A. It consists of an initial intensive phase and a later continuation phase
B. The dose of antitubercular drugs is reduced after clinical response occurs
C. The patient himself is made responsible for administering antitubercular drugs
D. All of the above are correct
53.25 The WHO guidelines for treatment of tuberculosis
with short course chemotherapy under the DOTS
strategy categorise patients on the basis of the following:
A. Site and severity of the disease
B. Sputum smear positivity/negativity
C. History of earlier antitubercular drug use
D. All of the above
53.26 According to the current WHO guidelines, new (untreated)
sputum smear positive cases of pulmonary tuberculosis
are to be treated with the following regimen:
A. Isoniazid + Rifampin + Pyrazinamide for 6 months
B. Isoniazid + Thiacetazone + Rifampin for 2
months followed by isoniazid + thiacetazone for 6 months
C. Isoniazid + Rifampin for 6 months with additional
Pyrazinamide + Ethambutol/Streptomycin during the initial 2 months
D. Isoniazid + Rifampin for 6 months with additional
Pyrazinamide during the initial 2 months
53.27 As per WHO guidelines, treatment of failure or relapse
(category II) patients of smear positive pulmonary
tuberculosis differs from that of new cases in the following respect(s):
A. All 5 first line antitubercular drugs are given in the initial intensive phase
B. Duration of intensive phase is increased to 5 months
C. Three drugs (HRE) are given in the
continuation phase instead of two (HR)
D. Both 'A' and 'C'
53.28 Chemoprophylaxis for tuberculosis is recommended
in the following category of subjects except:
A. Mantoux positive child in the family of a tuberculosis patient
B. All Mantoux positive adult contacts of tubercular patients
C. Adult contacts of sputum positive tuberculosis
patient who show Mantoux conversion
D. HIV positive subjects with a positive Mantoux test
53.29 The current WHO guidelines recommend isoniazid +
rifampin + pyrazinamide for initial 2 months followed
by isoniazid + rifampin for another 4 months for the
following category of tubercular patients:
A. New sputum positive cases of pulmonary tuberculosis
B. New sputum negative cases of pulmonary tuberculosis
C. Sputum positive patients of pulmonary
tuberculosis who have interrupted treatment
for more than 2 months
D. Tubercular meningitis patients
53.30 Under the WHO guidelines for treatment of new cases
of tuberculosis, when isoniazid + ethambutol are
used in the continuation phase instead of isoniazid +
rifampin,, the duration of this phase is:
A. 2 months
B. 4 months
C. 6 months
D. 8 months
53.31 A woman aged 25 years is diagnosed to be suffering
from pulmonary tuberculosis. She is also 8 weeks
pregnant. Antitubercular therapy for her should be:
A. Started immediately
B. Delayed till end of first trimester
C. Delayed till end of second trimester
D. Delayed till after confinement
53.32 Corticosteroids are absolutely contraindicated in the
following type of tuberculosis:
A. Miliary
B. Meningeal
C. Intestinal
D. Renal
53.33 Multidrug resistant (MDR) tuberculosis is defined as resistance to:
A. Any two or more antitubercular drugs
B. Isoniazid + any other antitubercular drug
C. Isoniazid + Rifampin + any one or more antitubercular drugs
D. All five first line antitubercular drugs
53.34 Mycobact. tuberculosis infection in a HIV infected
patient is treated with:
A. The same antitubercular regimen as HIV negative patient
B. Four first line antitubercular drugs for 2
months followed by a longer continuation
phase of 7 months with rifampin + isoniazid
C. All 5 first line antitubercular drugs for 9 months
D. Clarithromycin + Ciprofloxacin + Rifabutin for 12 months
53.35 The drugs used to treat Mycobact. avium complex
infection in AIDS patients include the following except:
A. Isoniazid
B. Clarithromycin
C. Ethambutol
D. Ciprofloxacin
Ans:
53.1 A 53.2 C 53.3D 53.4 A 53.5D 53.6 B 53.7 C 53.8 A 53.9 A 53.10 B 53.11 C 53.12 C 53.13 B 53.14 B 53.15D 53.16D 53.17 A 53.18 C 53.19 B 53.20 A 53.21 B 53.22D 53.23D 53.24 A 53.25D 53.26 C 53.27D 53.28 B 53.29 B 53.30 C 53.31 A 53.32 C 53.33 C 53.34 B 53.35 A
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