[MCQ] Tuberculosis- Part 2

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Tuberculosis- Part 2

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Question 1

Best characterized strain of M. tuberculosis is ?

A	H36R
B	H37R
C	H38R
D	H39R

Question 1 Explanation:

The best characterized strain of Mycobacterium tuberculosis is H37R.

Question 2

Mycobacterium tuberculosis is a slow-growing bacteria that divides every ?

A	16 - 20 hours
B	36 - 48 hours
C	48 - 60 hours
D	72 - 90 hours

Question 2 Explanation:

Mycobacterium tuberculosis is a slow-growing bacteria that divides every 16 - 20 hours. M. tuberculosis can only replicate & grow within a host organism.

Question 3

Which of the following best relates to the pathogenicity of Mycobacterium tuberculosis ?

A	Slow generation time
B	Phagolysosome formation
C	Phagosome maturation arrest
D	Resistance to osmotic lysis

Question 3 Explanation:

Phagosome maturation arrest best relates to pathogenicity of M. tuberculosis. Mycobaterial phagosomal maturation arrest is by LAM-mediated disruption of Ca2+ calmodulin dependent regulation of PI3P & EEA1 on phagosomes. These help keep vacuoles away from bactericidal and antigen processing organelles in infected macrophages. LAM prevents increases of Ca2+ surge, prevents the interaction of a kinase and downstream recruitment of EEA1. EEA1 and syntaxin 6 are necessary components of the lysosomal compartment.

Question 4

What fraction of inhaled droplet nuclei containing M. tuberculosis microorganisms reach the alveoli ?

A	10 %
B	15 %
C	20 %
D	25 %

Question 4 Explanation:

Majority of inhaled TB bacilli are trapped in upper airways and expelled by ciliated mucosal cells, about 10% reach the alveoli.

Question 5

Gene thought to confer virulence to M. tuberculosis is ?

A	katG
B	rpoV
C	erp
D	All of the above

Question 5 Explanation:

Genes that confer virulence to M. tuberculosis are katG, rpoV, erp. Defects in katG, rpoV genes result in loss of virulence. katG gene encodes for catalase/peroxidase enzymes that protect against oxidative stress, rpoV is the main sigma factor initiating transcription of several genes. Defects in these two genes result in loss of virulence. Product of rpoB gene is RNA polymerase. The erp gene, encoding a protein required for multiplication, also contributes to virulence.

Question 6

Beijing family of M. tuberculosis strains was described in year ?

A	1984
B	1990
C	1995
D	2000

Question 6 Explanation:

Beijing family of M. tuberculosis strains was described in 1995.

Question 7

Revised National Tuberculosis Control Program started in ?

A	1990
B	1993
C	1995
D	1998

Question 7 Explanation:

Revised National Tuberculosis Control Program was begun in 1993.

Question 8

Beijing/W genotype family of M. tuberculosis is associated with all except ?

A	Lower mortality rates
B	Multibanded IS6110 restriction fragment length polymorphism (RFLP) patterns
C	Highest density found in Beijing
D	Largest genotype family of M. tuberculosis

Question 8 Explanation:

Strains of the Beijing/W genotype family are associated with higher mortality rates. BCG-induced immunological defense may protect against most M. tuberculosis strains but not against selected genotypes (called escape variants), such as M. tuberculosis Beijing isolates. IS6110 sequence is not found in NTM.

Question 9

Which of the following is not a M. tuberculosis genotype family ?

A	Gibralter
B	Latino-American
C	Mediterranean
D	Haarlem

Question 9 Explanation:

M. tuberculosis genotype families are Beijing family, Latino-American and Mediterranean family, Haarlem family, the X clade.

Question 10

Which of the following gene in humans plays a role in determining susceptibility to tuberculosis ?

A	katG
B	rpoV
C	erp
D	NRAMP1

Question 10 Explanation:

In humans, NRAMP1 (chromosome 2q) may play a role in innate nonimmune resistance to infection with M. tuberculosis and development of disease.

Question 11

Cell mediated immunity (CMI) & humoral immunity begin how many weeks after M. tuberculosis infection ?

A	1 - 2
B	2 - 4
C	4 - 6
D	6 - 8

Question 11 Explanation:

Cell mediated immunity (CMI) & humoral immunity begin 2 - 4 weeks after M. tuberculosis infection.

Question 12

Which of the following is a “T cell - mediated phenomenon” ?

A	Fusion between phagosomes & lysosomes
B	Recruitment of immature monocyte-derived macrophages
C	Macrophage-activating response
D	Tissue-damaging response

Question 12 Explanation:

Macrophage-activating response is a T cell - mediated phenomenon resulting in activation of macrophages capable of killing & digesting tubercle bacilli.

Question 13

Which of the following is a “delayed-type hypersensitivity (DTH) reaction” ?

A	Fusion between phagosomes & lysosomes
B	Recruitment of immature monocyte-derived macrophages
C	Macrophage-activating response
D	Tissue-damaging response

Question 13 Explanation:

About 2-4 weeks after infection, two host responses to M. tuberculosis develop to inhibit mycobacterial growth. First, a macrophage-activating CMI response (T cell - mediated phenomenon) and second a tissue-damaging response (delayed-type hypersensitivity (DTH) reaction).

Question 14

Caseous necrosis of involved tissues is the result of ?

A	Fusion between phagosomes & lysosomes
B	Recruitment of immature monocyte-derived macrophages
C	Macrophage-activating response
D	Tissue-damaging response

Question 14 Explanation:

The tissue-damaging response destroys unactivated macrophages containing multiplying bacilli and causes caseous necrosis of involved tissues.

Question 15

Caseous necrosis may also be observed in ?

A	Neoplasms
B	Burns
C	Lymphedema
D	All of the above

Question 15 Explanation:

Soft cheese or caseous necrosis may also be observed in neoplasms.

Question 16

Growth of M. tuberculosis is inhibited by ?

A	Low oxygen tension
B	Low pH
C	Nitric oxide
D	All of the above

Question 16 Explanation:

Growth of M. tuberculosis is inhibited within necrotic environment by low oxygen tension & low pH. Monocytes & macrophages produce nitric oxide which has antimycobacterial activity.

Question 17

Which of the following plays a role in processing & presenting M. tuberculosis antigens to T lymphocytes ?

A	Alveolar macrophages
B	Monocytes
C	Dendritic cells
D	All of the above

Question 17 Explanation:

Alveolar macrophages, monocytes, and dendritic cells are critical in processing & presenting M. tuberculosis antigens to T lymphocytes.

Question 18

ESAT6 stands for ?

A	Essential secretory antigenic target 6
B	Epidemic secretory antigenic target 6
C	Early secretory antigenic target 6
D	Episodic secretory antigenic target 6

Question 19

CFP10 stands for ?

A	Culture filtrate protein 10
B	Cell filtrate protein 10
C	Cryo filtrate protein 10
D	Cytoplasmic filtrate protein 10

Question 19 Explanation:

Newer in-vitro T-cell based interferon gamma assays using early secretory antigenic target 6 (ESAT6) & culture filtrate protein 10 (CFP10) that are absent in BCG but are major targets of T-cell response to M tuberculosis are commercially available in ELISA & ELISPOT formats with higher sensitivity than tuberculin skin test (TST). They are less affected by malnutrition, HIV infection & BCG vaccination

Question 20

Which of the following statements about primary pulmonary tuberculosis is false ?

A	Seen in children
B	Localized to middle and lower lung zones
C	Lesion is central & accompanied by hilar or paratracheal lymphadenopathy
D	Lesion heals spontaneously

Question 20 Explanation:

Primary pulmonary tuberculosis results from an initial infection with tubercle bacilli. It is often seen in children and is frequently localized to middle and lower lung zones. The lesion forming after infection is usually “peripheral” and accompanied by hilar or paratracheal lymphadenopathy

Question 21

What is Ghon lesion ?

A	Calcified paratracheal lymph node
B	A small calcified TB nodule in lung
C	Hemorrhage in a tubercular cavity
D	None of the above

Question 21 Explanation:

In primary pulmonary tuberculosis, the lung lesion may heal spontaneously and appear as a small calcified nodule termed Ghon lesion at a later date.

Question 22

Post primary pulmonary tuberculosis is also called ?

A	Adult-type tuberculosis
B	Reactivation tuberculosis
C	Secondary tuberculosis
D	Any of the above

Question 22 Explanation:

Post primary pulmonary tuberculosis is also called adult-type, reactivation, or secondary tuberculosis.

Question 23

Which of the following about postprimary pulmonary tuberculosis is false ?

A	Due to endogenous reactivation of latent infection
B	Localized to apical & posterior segments of upper lobes
C	Superior segments of lower lobes frequently involved
D	None of the above

Question 23 Explanation:

Postprimary disease is due to endogenous reactivation of latent infection. It is usually localized to apical and posterior segments of the upper lobes & superior segments of lower lobes are frequently involved.

Question 24

The process of chronic, progressively debilitating course of postprimary pulmonary tuberculosis is also called ?

A	Consumption
B	Corrosion
C	Exasperate
D	Decay

Question 24 Explanation:

The process of chronic, progressively debilitating course of postprimary pulmonary tuberculosis is also called “consumption”.

Question 25

Rasmussen’s aneurysm refers to ?

A	Aortic aneurysm secondary to tuberculosis
B	Pulmonary artery aneurysm secondary to tuberculosis
C	Dilated vessel in a tubercular cavity
D	Dilatation of a major bronchus

Question 25 Explanation:

A dilated vessel in a tubercular cavity is called Rasmussen’s aneurysm. It can lead to hemoptysis.

Question 26

Massive hemoptysis in pulmonary TB is due to ?

A	Erosion of blood vessel in wall of a cavity
B	Rupture of a dilated vessel in a cavity
C	Aspergilloma formation in an old cavity
D	Any of the above

Question 26 Explanation:

Massive hemoptysis in pulmonary TB may be a consequence of erosion of a blood vessel in the wall of a cavity, from rupture of a dilated vessel in a cavity (Rasmussen’s aneurysm) or from aspergilloma formation in an old cavity.

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See all quizzes of Tuberculosis- Part 2 here:

1 Best characterized strain of M. tuberculosis is ?
A. H36R
B. H37R
C. H38R
D. H39R

2 Mycobacterium tuberculosis is a slow-growing bacteria that
divides every ?
A. 16 – 20 hours
B. 36 – 48 hours
C. 48 – 60 hours
D. 72 – 90 hours

3 Which of the following best relates to the pathogenicity of
Mycobacterium tuberculosis ?
A. Slow generation time
B. Phagolysosome formation
C. Phagosome maturation arrest
D. Resistance to osmotic lysis

4 What fraction of inhaled droplet nuclei containing M. tuberculosis
microorganisms reach the alveoli ?
A. 10 %
B. 15 %
C. 20 %
D. 25 %

5 Gene thought to confer virulence to M. tuberculosis is ?
A. katG
B. rpoV
C. erp
D. All of the above

6 Beijing family of M. tuberculosis strains was described in year ?
A. 1984
B. 1990
C. 1995
D. 2000

7 Revised National Tuberculosis Control Program started in ?
A. 1990
B. 1993
C. 1995
D. 1998

8 Beijing/W genotype family of M. tuberculosis is associated with
all except ?
A. Lower mortality rates
B. Multibanded IS6110 restriction fragment length polymorphism
(RFLP) patterns
C. Highest density found in Beijing
D. Largest genotype family of M. tuberculosis

9 Which of the following is not a M. tuberculosis genotype family ?
A. Gibralter
B. Latino-American
C. Mediterranean
D. Haarlem

10 Which of the following gene in humans plays a role in determining
susceptibility to tuberculosis ?
A. katG
B. rpoV
C. erp
D. NRAMP1

11 Cell mediated immunity (CMI) & humoral immunity begin how
many weeks after M. tuberculosis infection ?
A. 1 – 2
B. 2 – 4
C. 4 – 6
D. 6 – 8

12 Which of the following is a “T cell – mediated phenomenon” ?
A. Fusion between phagosomes & lysosomes
B. Recruitment of immature monocyte-derived macrophages
C. Macrophage-activating response
D. Tissue-damaging response

13 Which of the following is a “delayed-type hypersensitivity (DTH)
reaction” ?
A. Fusion between phagosomes & lysosomes
B. Recruitment of immature monocyte-derived macrophages
C. Macrophage-activating response
D. Tissue-damaging response

14 Caseous necrosis of involved tissues is the result of ?
A. Fusion between phagosomes & lysosomes
B. Recruitment of immature monocyte-derived macrophages
C. Macrophage-activating response
D. Tissue-damaging response

15 Caseous necrosis may also be observed in ?
A. Neoplasms
B. Burns
C. Lymphedema
D. All of the above
16 Growth of M. tuberculosis is inhibited by ?
A. Low oxygen tension
B. Low pH
C. Nitric oxide
D. All of the above

17 Which of the following plays a role in processing & presenting M.
tuberculosis antigens to T lymphocytes ?
A. Alveolar macrophages
B. Monocytes
C. Dendritic cells
D. All of the above

18 ESAT6 stands for ?
A. Essential secretory antigenic target 6
B. Epidemic secretory antigenic target 6
C. Early secretory antigenic target 6
D. Episodic secretory antigenic target 6
19 CFP10 stands for ?
A. Culture filtrate protein 10
B. Cell filtrate protein 10
C. Cryo filtrate protein 10
D. Cytoplasmic filtrate protein 10

20 Which of the following statements about primary pulmonary
tuberculosis is false ?
A. Seen in children
B. Localized to middle and lower lung zones
C. Lesion is central & accompanied by hilar or paratracheal
lymphadenopathy
D. Lesion heals spontaneously

21 What is Ghon lesion ?
A. Calcified paratracheal lymph node
B. A small calcified TB nodule in lung
C. Hemorrhage in a tubercular cavity
D. None of the above

22 Post primary pulmonary tuberculosis is also called ?
A. Adult-type tuberculosis
B. Reactivation tuberculosis
C. Secondary tuberculosis
D. Any of the above

23 Which of the following about postprimary pulmonary tuberculosis
is false ?
A. Due to endogenous reactivation of latent infection
B. Localized to apical & posterior segments of upper lobes
C. Superior segments of lower lobes frequently involved
D. None of the above

24 The process of chronic, progressively debilitating course of
postprimary pulmonary tuberculosis is also called ?
A. Consumption
B. Corrosion
C. Exasperate
D. Decay

25 Rasmussen’s aneurysm refers to ?
A. Aortic aneurysm secondary to tuberculosis
B. Pulmonary artery aneurysm secondary to tuberculosis
C. Dilated vessel in a tubercular cavity
D. Dilatation of a major bronchus

26 Massive hemoptysis in pulmonary TB is due to ?
A. Erosion of blood vessel in wall of a cavity
B. Rupture of a dilated vessel in a cavity
C. Aspergilloma formation in an old cavity
D. Any of the above

Tuberculosis

[MCQ] Tuberculosis- Part 2

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Tuberculosis- Part 2

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