[MCQ] Tuberculosis- Part 4

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Tuberculosis- Part 4

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Congratulations - you have completed Tuberculosis- Part 4. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

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Question 1

Which of the following is most commonly involved in gastrointestinal tuberculosis ?

A	Duodenum
B	Cecum
C	Rectum
D	Anal canal

Question 1 Explanation:

Any portion of the gastrointestinal tract may be affected by tuberculosis. Terminal ileum and cecum are the sites most commonly involved.

Question 2

The mechanism of tuberculous peritonitis is ?

A	Direct spread of tubercle bacilli from ruptured lymph nodes
B	Direct spread of tubercle bacilli from intraabdominal or
C	Hematogenous seeding
D	Any of the above

Question 2 Explanation:

Tuberculous peritonitis occurs either by direct spread of tubercle bacilli from ruptured lymph nodes and intraabdominal organs or hematogenous seeding.

Question 3

In miliary tuberculosis, the colour of granuloma lesions is ?

A	Brown
B	Yellow
C	Black
D	White

Question 3 Explanation:

Lesions in miliary tuberculosis are yellowish granulomas, 1 to 2 mm in diameter resembling millet seeds.

Question 4

Out of the following, which one is pathognomonic of miliary tuberculosis ?

A	Hepatomegaly
B	Splenomegaly
C	Lymphadenopathy
D	Choroidal tubercles

Question 4 Explanation:

Clinical manifestations of miliary tuberculosis are protean. Hepatomegaly, splenomegaly, and lymphadenopathy are frequent physical findings. Choroidal tubercles in eye examination is pathognomonic of miliary tuberculosis

Question 5

Miliary reticulonodular pattern is more easily seen on chest radiography that is ?

A	Underpenetrated
B	Overpenetrated
C	Ideally exposed
D	Any of the above

Question 5 Explanation:

In miliary tuberculosis, chest radiography reveals a miliary reticulonodular pattern that is more easily seen on underpenetrated film.

Question 6

HRCT finding in miliary tuberculosis is termed as ?

A	Glazed glass appearance
B	White froth appearance
C	Snowstorm appearance
D	Sandstorm appearance

Question 6 Explanation:

Coalescing nodules result into patchy irregular opacities and HRCT shows this variation effectively and has been described as “snowstorm appearance”.

Question 7

Cryptic miliary tuberculosis is mostly seen in ?

A	Neonates
B	Children
C	Adults
D	Elderly

Question 7 Explanation:

Cryptic miliary tuberculosis is seen in elderly. It has a chronic course characterized by mild intermittent fever, anemia, and ultimately meningeal involvement preceding death.

Question 8

Pancytopenia is common in which of the following ?

A	Miliary tuberculosis
B	Cryptic miliary tuberculosis
C	Nonreactive miliary tuberculosis
D	All of the above

Question 8 Explanation:

Nonreactive miliary tuberculosis is an acute septicemic form, due to massive hematogenous dissemination of tubercle bacilli. Pancytopenia is common. Histopathologically, multiple necrotic but nongranulomatous (“nonreactive”) lesions are detected.

Question 9

Which of the following is false about ‘Lupus vulgaris’ ?

A	A form of cutaneous tuberculosis
B	Seen in previously infected and sensitized individuals
C	Most lesions occur in head and neck area
D	None of the above

Question 9 Explanation:

Lupus vulgaris is a form of cutaneous tuberculosis that is seen in previously infected and sensitized individuals. Most lesions occur in head and neck area and are red-brown plaques with a yellowbrown color on diascopy.

Question 10

Which of the following statements about tuberculosis in HIVinfected patients is false ?

A	Increased frequency of sputum-smear negativity
B	Atypical radiographic findings
C	Lack of classic granuloma formation in early stages
D	Negative TST

Question 10 Explanation:

In tuberculosis in HIV-infected patients there is increased frequency of sputum-smear negativity, atypical radiographic findings (lower-zone infiltrates without cavity formation), lack of classic granuloma formation in late stages and negative TST.

Question 11

Tissue specimen intended for tubercular culture should not be put in ?

A	Saline
B	Alcohol
C	Formaldehyde
D	Any of the above

Question 11 Explanation:

Tissue specimen intended for tubercular culture should not be put in formaldehyde

Question 12

Which of the following is used for staining AFB ?

A	Auramine-rhodamine staining
B	Kinyoun staining
C	Ziehl-Neelsen staining
D	All of the above

Question 13

Ziehl-Neelsen staining requires how many bacilli / ml ?

A	102 bacilli / ml
B	103 bacilli / ml
C	104 bacilli / ml
D	105 bacilli / ml

Question 13 Explanation:

ZN staining requires 105 bacilli / ml.

Question 14

Which of the following culture medium is used to grow mycobacteria ?

A	Lowenstein - Jensen (LJ)
B	Middlebrook 7H10
C	Kirschner’s
D	All of the above

Question 14 Explanation:

Three types of culture media are used to grow mycobacteria - Egg based (LJ, Petragnani and ATS), Agar based (Middlebrook 7H10 or 7H11) and Liquid based (Kirschner’s, Middlebrook 7H9).

Question 15

Biochemical marker test for diagnosis of tuberculosis is ?

A	Adenosine deaminase (ADA)
B	Bromide partition test
C	Gas chromatography of mycobacterial fatty acids (Tuberculostearic acid)
D	All of the above

Question 16

Adenosine deaminase (ADA) catalyzes the conversion of adenosine to ?

A	Lysine
B	Inosine
C	Homocysteine
D	Glycine

Question 16 Explanation:

Adenosine deaminase (ADA) catalyzes the conversion of adenosine to inosine and is relaeased by lymphocytes and macrophages during the cellular immune response. (Adenosine + H2O + ADA = Inosine + NH3 +ADA). ADA is also found in inflammatory fluids associated with RA, lymphoma, empyema, parapneunomic effusions and mesothelioma

Question 17

Patients with TB pleurisy have which type of ADA ?

A	ADA1
B	ADA2
C	ADA3
D	ADA4

Question 17 Explanation:

Enzyme ADAp or “total pleural ADA level” is typically found at high concentrations in pleural TB. ADA1 is found in all cells and ADA2 reflects monocyte/macrophage activation. Patients with TB pleurisy have predominantly ADA2, whilst those with empyema and parainfective effusions have mainly ADA1. Ratio of ADA1 / ADAp <0.42 is a good indicator of TB pleurisy.

Question 18

Which of the following radiographic pattern is considered pathognomonic for pulmonary tuberculosis ?

A	Normal film
B	Upper lobe disease with infiltrates and cavities
C	Solitary pulmonary nodule
D	None of the above

Question 18 Explanation:

Although “classic” radiographic picture of pulmonary tuberculosis is upper lobe disease with infiltrates and cavities, virtually any radiographic pattern from a normal film or a solitary pulmonary nodule to diffuse alveolar infiltrates can be encountered. No radiographic pattern can be considered pathognomonic.

Question 19

For the diagnosis of primary pulmonary tuberculosis in children, who often do not expectorate sputum, specimen for culture can be obtained from ?

A	Nasal secretion
B	Throat swab
C	Early-morning gastric lavage
D	Faeces

Question 19 Explanation:

For the diagnosis of primary pulmonary tuberculosis in children, who often do not expectorate sputum, specimens from early-morning gastric lavage may yield positive cultures.

Question 20

Master batch of PPD produced on directions of WHO and UNICEF was termed as ?

A	RT21
B	RT22
C	RT23
D	RT24

Question 20 Explanation:

PPD-S was developed by Seibert and Glenn in 1941. WHO and UNICEF later sponsored largescale production of a master batch of PPD, termed RT23, and made it available for general use.

Question 21

IGRAs stands for ?

A	IFN- Related Assays
B	IFN- Response Assays
C	IFN-γ Requiring Assays
D	IFN-IFN-γ Release Assays

Question 21 Explanation:

IGRAs stands for IFN- Release Assays.

Question 22

Which of the following antituberculosis medication causes elevated uric acid level ?

A	Rifampin
B	Pyrazinamide
C	Isoniazid
D	Streptomycin

Question 22 Explanation:

Hyperuricemia is a common adverse effect of pyrazinamide therapy. Its incidence is reduced by concurrent rifampin therapy. Clinical gout is rare

Question 23

Which of the following antituberculosis medication causes elevated uric acid level ?

A	Rifampin
B	Ethambutol
C	Isoniazid
D	Streptomycin

Question 23 Explanation:

Adverse effects of ethambutol includes hyperuricemia but is usually asymptomatic.

Question 24

Which of the following antitubercular medication causes hypothyroidism ?

A	Rifampin
B	Ethionamide
C	Isoniazid
D	Streptomycin

Question 24 Explanation:

Ethionamide is most useful in treatment of MDR tuberculosis. Its toxicity include intense gastrointestinal intolerance, serious neurologic reactions, reversible hepatitis, hypersensitivity reactions & hypothyroidism.

Question 25

Which of the following antitubercular drug acts by impairing folate synthesis of M. tuberculosis ?

A	Capreomycin
B	Ethionamide
C	Para-Aminosalicylic Acid (PAS)
D	Ethambutol

Question 25 Explanation:

PAS inhibits the growth of M. tuberculosis by impairing folate synthesis.

Question 26

Revised National Tuberculosis Control Program was begun in which year ?

A	1991
B	1992
C	1993
D	1994

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See all quizzes of Tuberculosis- Part 4 here:

1 Which of the following is most commonly involved in
gastrointestinal tuberculosis ?
A. Duodenum
B. Cecum
C. Rectum
D. Anal canal

2 The mechanism of tuberculous peritonitis is ?
A. Direct spread of tubercle bacilli from ruptured lymph nodes
B. Direct spread of tubercle bacilli from intraabdominal organ
C. Hematogenous seeding
D. Any of the above

3 In miliary tuberculosis, the colour of granuloma lesions is ?
A. Brown
B. Yellow
C. Black
D. White

4 Out of the following, which one is pathognomonic of miliary
tuberculosis ?
A. Hepatomegaly
B. Splenomegaly
C. Lymphadenopathy
D. Choroidal tubercles

5 Miliary reticulonodular pattern is more easily seen on chest
radiography that is ?
A. Underpenetrated
B. Overpenetrated
C. Ideally exposed
D. Any of the above

6 HRCT finding in miliary tuberculosis is termed as ?
A. Glazed glass appearance
B. White froth appearance
C. Snowstorm appearance
D. Sandstorm appearance

7 Cryptic miliary tuberculosis is mostly seen in ?
A. Neonates
B. Children
C. Adults
D. Elderly

8 Pancytopenia is common in which of the following ?
A. Miliary tuberculosis
B. Cryptic miliary tuberculosis
C. Nonreactive miliary tuberculosis
D. All of the above

9 Which of the following is false about ‘Lupus vulgaris’ ?
A. A form of cutaneous tuberculosis
B. Seen in previously infected and sensitized individuals
C. Most lesions occur in head and neck area
D. None of the above

10 Which of the following statements about tuberculosis in HIVinfected
patients is false ?
A. Increased frequency of sputum-smear negativity
B. Atypical radiographic findings
C. Lack of classic granuloma formation in early stages
D. Negative TST

11 Tissue specimen intended for tubercular culture should not be
put in ?
A. Saline
B. Alcohol
C. Formaldehyde
D. Any of the above

12 Which of the following is used for staining AFB ?
A. Auramine-rhodamine staining
B. Kinyoun staining
C. Ziehl-Neelsen staining
D. All of the above
13 Ziehl-Neelsen staining requires how many bacilli / ml ?
A. 102 bacilli / ml
B. 103 bacilli / ml
C. 104 bacilli / ml
D. 105 bacilli / ml

14 Which of the following culture medium is used to grow
mycobacteria ?
A. Lowenstein – Jensen (LJ)
B. Middlebrook 7H10
C. Kirschner’s
D. All of the above

15 Biochemical marker test for diagnosis of tuberculosis is ?
A. Adenosine deaminase (ADA)
B. Bromide partition test
C. Gas chromatography of mycobacterial fatty acids
(Tuberculostearic acid)
D. All of the above

16 Adenosine deaminase (ADA) catalyzes the conversion of adenosine
to ?
A. Lysine
B. Inosine
C. Homocysteine
D. Glycine

17 Patients with TB pleurisy have which type of ADA ?
A. ADA1
B. ADA2
C. ADA3
D. ADA4

18 Which of the following radiographic pattern is considered
pathognomonic for pulmonary tuberculosis ?
A. Normal film
B. Upper lobe disease with infiltrates and cavities
C. Solitary pulmonary nodule
D. None of the above

19 For the diagnosis of primary pulmonary tuberculosis in children,
who often do not expectorate sputum, specimen for culture can
be obtained from ?
A. Nasal secretion
B. Throat swab
C. Early-morning gastric lavage
D. Faeces

20 Master batch of PPD produced on directions of WHO and UNICEF
was termed as ?
A. RT21
B. RT22
C. RT23
D. RT24

21 IGRAs stands for ?
A. IFN- Related Assays
B. IFN- Response Assays
C. IFN- Requiring Assays
D. IFN- Release Assays

22 Which of the following antituberculosis medication causes elevated
uric acid level ?
A. Rifampin
B. Pyrazinamide
C. Isoniazid
D. Streptomycin

23 Which of the following antituberculosis medication causes elevated
uric acid level ?
A. Rifampin
B. Ethambutol
C. Isoniazid
D. Streptomycin

24 Which of the following antitubercular medication causes
hypothyroidism ?
A. Rifampin
B. Ethionamide
C. Isoniazid
D. Streptomycin

25 Which of the following antitubercular drug acts by impairing
folate synthesis of M. tuberculosis ?
A. Capreomycin
B. Ethionamide
C. Para-Aminosalicylic Acid (PAS)
D. Ethambutol

26 Revised National Tuberculosis Control Program was begun in
which year ?
A. 1991
B. 1992
C. 1993
D. 1994
529 Which of the fol

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[MCQ] Tuberculosis- Part 4

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Tuberculosis- Part 4

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