[MCQ] Tuberculosis- Part 7

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Tuberculosis- Part 7

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Congratulations - you have completed Tuberculosis- Part 7. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

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Question 1

Tuberculosis affects which bone more frequently ?

A	Spine
B	Metaphyses of long bones
C	Ribs
D	Sternum

Question 1 Explanation:

Tuberculosis and brucellosis affect the spine more often than other bones. Thoracic spine is involved most commonly in tuberculous spondylitis (Pott’s disease).

Question 2

Streptomycin is the drug of choice in initial therapy for ?

A	Tularemia
B	Plague
C	Brucellosis
D	All of the above

Question 2 Explanation:

Streptomycin is drug of choice in initial therapy for tularemia, plague, glanders & brucellosis.

Question 3

Which of the following is false about tubercular vertebral osteomyelitis ?

A	Site mostly affected is dorsolumbar spine
B	Diskitis is late
C	Spinal canal compression common
D	Psoas abscess likely

Question 3 Explanation:

Diskitis is early in tuberculosis while it is late in brucellosis. Also, in brucellosis, the spinal canal compression and psoas abscess are rare.

Question 4

Which of the following antimycobacterial agents have no or minimal effects on other drugs ?

A	Amikacin
B	Ethambutol
C	Pyrazinamide
D	All of the above

Question 4 Explanation:

Antimycobacterials that have no / minimal effects on other drugs are amikacin, azithromycin, capreomycin, ethambutol, streptomycin, & pyrazinamide.

Question 5

Which of the following is not a “first-line essential anti-tuberculous agent” ?

A	Rifampin
B	Isoniazid
C	Streptomycin
D	Pyrazinamide

Question 5 Explanation:

Four first-line essential antituberculous agents are rifampin, isoniazid, ethambutol & pyrazinamide

Question 6

Which of the following is a “first-line supplemental antituberculous agent” ?

A	Rifampin
B	Isoniazid
C	Streptomycin
D	Pyrazinamide

Question 6 Explanation:

First-line “supplemental” agents include rifabutin, rifapentine, and streptomycin.

Question 7

Which of the following is not a “second-line anti-tuberculous drug” ?

A	Levofloxacin
B	Ethionamide
C	Ethambutol
D	Amikacin

Question 7 Explanation:

Second-line antituberculous drugs are para-aminosalicylic acid (PAS), ethionamide, cycloserine, amikacin, kanamycin, capreomycin, and fluoroquinolones.

Question 8

Which of the following drugs is bacteriostatic against resting bacilli & bactericidal against rapidly multiplying organisms, both extracellularly & intracellularly ?

A	Rifampin
B	Isoniazid
C	Ethambutol
D	Pyrazinamide

Question 9

Isoniazid is bactericidal against ?

A	Resting bacilli
B	Rapidly multiplying bacilli
C	Injured bacilli
D	All of the above

Question 9 Explanation:

Isoniazid is bacteriostatic against resting bacilli and bactericidal against rapidly multiplying organisms, both extracellularly and intracellularly.

Question 10

Isoniazid-associated hepatitis increases in ?

A	Age
B	Daily alcohol consumption
C	Concomitant rifampin administration
D	All of the above

Question 11

Isoniazid-associated hepatitis increases in ?

A	HIV infection
B	Pregnant women
C	Postpartum period
D	All of the above

Question 11 Explanation:

Isoniazid-associated hepatitis is idiosyncratic and increases in incidence with age, daily alcohol consumption, concomitant rifampin administration, and HIV infection as well as in women who are pregnant or in postpartum period.

Question 12

Isoniazid should be discontinued when there is asymptomatic elevation of ALT level that exceed how many times the upper limit of normal ?

A	Two times
B	Three times
C	Five times
D	Seven times

Question 13

Rifampin is a semisynthetic derivative of ?

A	Streptomyces victorii
B	Streptomyces griseus
C	Streptomyces mediterranei
D	Streptomyces perii

Question 13 Explanation:

Rifampin is a semisynthetic derivative of Amycolatopsis rifamycinica formerly known as Streptomyces mediterranei.

Question 14

Rifampin is also active against ?

A	Legionella spp.
B	M. kansasii
C	M. marinum
D	All of the above

Question 14 Explanation:

Rifampin is also active against some gram-positive & gram-negative bacteria, Legionella spp., M. kansasii, and M. marinum.

Question 15

Which of the following body fluids is turned red-orange in color by rifampin ?

A	Urine
B	Saliva
C	Sputum
D	All of the above

Question 15 Explanation:

Rifampin turns urine, saliva, sputum and tears to a red-orange color.

Question 16

Which of the following is best related to rifampin ?

A	Aminosalicylic acid
B	Sulphonylurea
C	Macrocyclic antibiotic
D	Trimethoprim

Question 16 Explanation:

Rifampin is a fat-soluble complex macrocyclic antibiotic

Question 17

Which of the following is false about rifampin ?

A	Intracellular & extracellular bactericidal activity
B	Blocks RNA synthesis
C	Inhibits DNA-dependent RNA polymerase
D	Water-soluble

Question 17 Explanation:

Rifampin is a fat-soluble and has intracellular & extracellular bactericidal activity. It blocks RNA synthesis by specifically binding & inhibiting DNA-dependent RNA polymerase

Question 18

Most common adverse effect of rifampin is ?

A	Skin rash
B	Hepatitis
C	Gastrointestinal upset
D	Thrombocytopenia

Question 18 Explanation:

Most common adverse effect of rifampin is gastrointestinal upset. It causes hepatocellular injury when given in combination with isoniazid or pyrazinamide. Skin rash, hemolytic anemia, thrombocytopenia, and immunosuppression of infrequent.

Question 19

Rifampin decreases half-life of which of the following drugs ?

A	Digoxin
B	Prednisone
C	HIV protease inhibitors
D	All of the above

Question 19 Explanation:

Rifampin is a potent inducer of hepatic microsomal enzymes and decreases half-life of digoxin, warfarin, prednisone, cyclosporine, methadone, oral contraceptives, clarithromycin, HIV protease inhibitors, HIV nonnucleoside reverse transcriptase inhibitors, and quinidine.

Question 20

Among the first-line drugs, which one is the least potent against M. tuberculosis ?

A	Isoniazid
B	Rifampin
C	Ethambutol
D	Pyrazinamide

Question 20 Explanation:

Among first-line drugs, ethambutol is the least potent against M. tuberculosis.

Question 21

Primary mechanism of action of ethambutol relates best to ?

A	DNA-dependent RNA polymerase
B	Catalase-peroxidase reaction
C	Arabinosyltransferase
D	Ribosome

Question 21 Explanation:

Ethambutol is a water-soluble compound (derivative of ethylenediamine), that is bacteriostatic only against mycobacteria like M. tuberculosis, M. marinum, M. kansasii, and MAC organisms. Primary mechanism of action is inhibition of an arabinosyltransferase that mediates the polymerization of arabinose into arabinogalactan within mycobacterial cell wall.

Question 22

Retrobulbar optic neuritis as a complication of ethambutol therapy results in loss of vision for which colour ?

A	Red
B	Blue
C	Green
D	Yellow

Question 22 Explanation:

Retrobulbar optic neuritis due to ethambutol therapy results in reduced visual acuity, central scotoma, and loss of ability to see green. Optic neuritis with associated visual loss is reversible, but recovery may take >6 months.

Question 23

Retrobulbar optic neuritis as a complication of ethambutol therapy can lead to ?

A	Reduced visual acuity
B	Central scotoma
C	Loss of ability to see green
D	All of the above

Question 23 Explanation:

Retrobulbar optic neuritis involves papillomacular bundle of fibers & results in reduced visual acuity, central scotoma, and loss of ability to see green.

Question 24

Perioral paresthesia and eosinophilia are adverse effects of which of the following drugs ?

A	Isoniazid
B	Rifampin
C	Streptomycin
D	Pyrazinamide

Question 24 Explanation:

Adverse effects of Streptomycin include renal toxicity (nonoliguric renal failure), ototoxicity (hearing loss & vestibular dysfunction), perioral paresthesia, eosinophilia, rash and drug fever.

Question 25

Ototoxicity in patients receiving streptomycin include ?

A	Hearing loss
B	Vertigo
C	Tinnitus
D	All of the above

Question 25 Explanation:

Ototoxicity in patients receiving streptomycin include both hearing loss and vestibular dysfunction like loss of balance, vertigo, and tinnitus

Question 26

Mean serum half-life of Rifabutin is ?

A	24 hours
B	45 hours
C	62 hours
D	78 hours

Question 26 Explanation:

Slow clearance of rifabutin via hepatic metabolism & renal excretion results in mean serum half-life of 45 hours, which is much longer than 3- to 5-hour half-life of rifampin. Clarithromycin (not azithromycin) & fluconazole block hepatic metabolism of rifabutin with consequent increases in its serum levels

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See all quizzes of Tuberculosis- Part 7 here:

1 Tuberculosis affects which bone more frequently ?
A. Spine
B. Metaphyses of long bones
C. Ribs
D. Sternum

2 Streptomycin is the drug of choice in initial therapy for ?
A. Tularemia
B. Plague
C. Brucellosis
D. All of the above

3 Which of the following is false about tubercular vertebral
osteomyelitis ?
A. Site mostly affected is dorsolumbar spine
B. Diskitis is late
C. Spinal canal compression common
D. Psoas abscess likely

4 Which of the following antimycobacterial agents have no or
minimal effects on other drugs ?
A. Amikacin
B. Ethambutol
C. Pyrazinamide
D. All of the above

5 Which of the following is not a “first-line essential anti-tuberculous
agent” ?
A. Rifampin
B. Isoniazid
C. Streptomycin
D. Pyrazinamide

6 Which of the following is a “first-line supplemental antituberculous
agent” ?
A. Rifampin
B. Isoniazid
C. Streptomycin
D. Pyrazinamide

7 Which of the following is not a “second-line anti-tuberculous
drug” ?
A. Levofloxacin
B. Ethionamide
C. Ethambutol
D. Amikacin

8 Which of the following drugs is bacteriostatic against resting
bacilli & bactericidal against rapidly multiplying organisms, both
extracellularly & intracellularly ?
A. Rifampin
B. Isoniazid
C. Ethambutol
D. Pyrazinamide
9 Isoniazid is bactericidal against ?
A. Resting bacilli
B. Rapidly multiplying bacilli
C. Injured bacilli
D. All of the above

10 Isoniazid-associated hepatitis increases in ?
A. Age
B. Daily alcohol consumption
C. Concomitant rifampin administration
D. All of the above
11 Isoniazid-associated hepatitis increases in ?
A. HIV infection
B. Pregnant women
C. Postpartum period
D. All of the above

12 Isoniazid should be discontinued when there is asymptomatic
elevation of ALT level that exceed how many times the upper limit
of normal ?
A. Two times
B. Three times
C. Five times
D. Seven times

13 Rifampin is a semisynthetic derivative of ?
A. Streptomyces victorii
B. Streptomyces griseus
C. Streptomyces mediterranei
D. Streptomyces perii

14 Rifampin is also active against ?
A. Legionella spp.
B. M. kansasii
C. M. marinum
D. All of the above

15 Which of the following body fluids is turned red-orange in color
by rifampin ?
A. Urine
B. Saliva
C. Sputum
D. All of the above

16 Which of the following is best related to rifampin ?
A. Aminosalicylic acid
B. Sulphonylurea
C. Macrocyclic antibiotic
D. Trimethoprim

17 Which of the following is false about rifampin ?
A. Intracellular & extracellular bactericidal activity
B. Blocks RNA synthesis
C. Inhibits DNA-dependent RNA polymerase
D. Water-soluble

18 Most common adverse effect of rifampin is ?
A. Skin rash
B. Hepatitis
C. Gastrointestinal upset
D. Thrombocytopenia

19 Rifampin decreases half-life of which of the following drugs ?
A. Digoxin
B. Prednisone
C. HIV protease inhibitors
D. All of the above

20 Among the first-line drugs, which one is the least potent against
M. tuberculosis ?
A. Isoniazid
B. Rifampin
C. Ethambutol
D. Pyrazinamide

21 Primary mechanism of action of ethambutol relates best to ?
A. DNA-dependent RNA polymerase
B. Catalase-peroxidase reaction
C. Arabinosyltransferase
D. Ribosome

22 Retrobulbar optic neuritis as a complication of ethambutol therapy
results in loss of vision for which colour ?
A. Red
B. Blue
C. Green
D. Yellow

23 Retrobulbar optic neuritis as a complication of ethambutol therapy
can lead to ?
A. Reduced visual acuity
B. Central scotoma
C. Loss of ability to see green
D. All of the above

24 Perioral paresthesia and eosinophilia are adverse effects of which
of the following drugs ?
A. Isoniazid
B. Rifampin
C. Streptomycin
D. Pyrazinamide

25 Ototoxicity in patients receiving streptomycin include ?
A. Hearing loss
B. Vertigo
C. Tinnitus
D. All of the above

26 Mean serum half-life of Rifabutin is ?
A. 24 hours
B. 45 hours
C. 62 hours
D. 78 hours

Tuberculosis

[MCQ] Tuberculosis- Part 7

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Tuberculosis- Part 7

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