Antituberculosis drugs mcqs with answers.pptx

Anti tb drugs l

1. MCQ’s on Anti-Tubercular Drugs

2. Which of the following anti-tubercular drug is bacteriostatic? a. Ethambutol b. Isoniazid c. Pyrazinamide d. Rifampicin

3. Which of the following anti-tubercular drug is bacteriostatic? a. Ethambutol b. Isoniazid c. Pyrazinamide d. Rifampicin Drug MOA ISONIAZID(H) Both extra and intracellular activity Inhibit fatty acid and mycolic acid synthesis of cell wall (BACTERICIDAL) RIFAMPICIN(R) Both extra and intracellular activity DNA dependent RNA polymerase inhibitor (BACTRICIDAL) ETHAMBUTOL extracellular activity Inhibit arbinosyl transferase(inhibit fatty acid synthesis) BACTERIOSTATIC PYRAZINAMIDE Intracellular activity Inhibit fatty acid synthesis and disrupts mycolic acid BACTRICIDAL

4. A 68-year-old man with hypertension was diagnosed with drug-resistant pulmonary TB. One week after starting ATT he presented to the casualty following an episode of syncope. ECG showed a corrected QT interval of 477ms. Which drug used in his anti-tubercular therapy is responsible for this adverse effect? A. Clofazimine B. Isoniazid C. Bedaquiline D. Para-amino salicylic acid

5. A 68-year-old man with hypertension was diagnosed with drug-resistant pulmonary TB. One week after starting ATT he presented to the casualty following an episode of syncope. ECG showed a corrected QT interval of 477ms. Which drug used in his anti-tubercular therapy is responsible for this adverse effect? A. Clofazimine B. Isoniazid C. Bedaquiline D. Para-amino salicylic acid Bedaquiline inhibits the ATP synthase of Mycobacterium tuberculosis, disrupting energy production and killing the bacteria. It is primarily used for drug-resistant tuberculosis (MDR-TB). Side effects include QT interval prolongation, hepatotoxicity, nausea, headache, and arthralgia. Close monitoring of heart function and liver enzymes is recommended.

6. Which is the most hepatotoxic antitubercular drug? (A) Isoniazid (B) Rifapentine (C) Pyrazinamide (D) Ethambutol

7. Which is the most hepatotoxic antitubercular drug? (A) Isoniazid (B) Rifapentine (C) Pyrazinamide (D) Ethambutol

8. A 25 year old female is under DOTS treatment for tuberculosis. She reports that she has blurred vision and unable differentiate red and green color. Which of the following drug is likely to produce above effects. (A) Isoniazid (B) Rifapentine (C) Pyrazinamide (D) Ethambutol

9. A 25 year old female is under DOTS treatment for tuberculosis. She reports that she has blurred vision and unable differentiate red and green color. Which of the following drug is likely to produce above effects. (A) Isoniazid (B) Rifapentine (C) Pyrazinamide (D) Ethambutol Ethambutol acts by inhibiting arbinosyl transferase(inhibit fatty acid synthesis). Side-effects include Retrobulbar neuritis , central scotoma, red green blindness, hyperuricemia.

10. Mutations in katG gene of Mycobacterium tuberculosis are responsible for resistance to: A. Isoniazid B. Rifampicin C. Pyrazinamide D. Streptomycin

11. Mutations in katG gene of Mycobacterium tuberculosis are responsible for resistance to: A. Isoniazid B. Rifampicin C. Pyrazinamide D. Streptomycin Isoniazid acts by inhibiting fatty acid and mycolic acid synthesis of cell wall Mechanism of resistance : Kat gene(m/c) InhA overexpression

12. What is the mechanism of action of delamanid ? A. Inhibition of ATP synthase B. Inhibition of mycolic acid synthesis C. Inhibition of DNA gyrase D. Inhibition of alanine racemase

13. What is the mechanism of action of delamanid ? A. Inhibition of ATP synthase B. Inhibition of mycolic acid synthesis C. Inhibition of DNA gyrase D. Inhibition of alanine racemase Delamanid is an anti-TB drug used to treat multidrug-resistant and extensively drug-resistant tuberculosis by inhibiting mycolic acid synthesis. It inhibits the synthesis of mycolic acids, which are essential components of the bacterial cell wall of Mycobacterium tuberculosis. By targeting this critical component, it disrupts the integrity of the bacterial cell wall, thereby preventing the growth and replication of the bacteria.

14. A 55-year-old man on treatment for TB presents with complaints of severe pain and swelling in his left great toe since today morning, as shown in the image below. Which of the following drugs is most likely to cause this? Rifampicin Pyrazinamide Isoniazid Streptomycin

15. A 55-year-old man on treatment for TB presents with complaints of severe pain and swelling in his left great toe since today morning, as shown in the image below. Which of the following drugs is most likely to cause this? Rifampicin Pyrazinamide Isoniazid Streptomycin Pyrazinamide acts by inhibiting Mycobacterium tuberculosis's fatty acid synthesis, disrupting cell membrane integrity. Side effects include hepatotoxicity, arthralgia, nausea, vomiting, and hyperuricemia (elevated uric acid levels)

16. A 30-year-old man undergoing treatment for TB visits your OPD for follow-up. His wife states that recently he is forgetting the names of his colleagues and neighbors, but later recollects them correctly. Which drug is implicated to cause this condition? A. Ethionamide B. Isoniazid C. Ethambutol D. Pyrazinamide

17. A 30-year-old man undergoing treatment for TB visits your OPD for follow-up. His wife states that recently he is forgetting the names of his colleagues and neighbors, but later recollects them correctly. Which drug is implicated to cause this condition? A. Ethionamide B. Isoniazid C. Ethambutol D. Pyrazinamide Isoniazid-induced psychosis is a rare but serious side effect of the anti-tuberculosis drug isoniazid. It occurs when the drug causes neurological or psychiatric disturbances, including confusion, hallucinations, delusions, and other symptoms of psychosis. While isoniazid is effective in treating tuberculosis, it can cross the blood-brain barrier and, in some cases, lead to neurotoxic effects

18. Before initiating treatment for a sputum-positive TB patient, the physician orders for Cartridge Based Nucleic Acid Amplification Test in order to test for drug resistance. Which anti-tubercular drug resistance is he checking for? Isoniazid Rifampicin Pyrazinamide Ethambutol

19. Before initiating treatment for a sputum-positive TB patient, the physician orders for Cartridge Based Nucleic Acid Amplification Test in order to test for drug resistance. Which anti-tubercular drug resistance is he checking for? Isoniazid Rifampicin Pyrazinamide Ethambutol CBNAAT (Cartridge-Based Nucleic Acid Amplification Test) is a rapid molecular diagnostic test for tuberculosis (TB) and rifampicin resistance. It detects Mycobacterium tuberculosis DNA within 2 hours, offering high sensitivity, especially in detecting drug-resistant TB in resource-limited settings.

20. In severe liver disease which of the following combination of antitubercular drug can be used? a) Isoniazid + Streptomycin b) Rifampicin + Isoniazid c) Rifampicin + Ethambutol d) Streptomycin + Ethambutol

21. In severe liver disease which of the following combination of antitubercular drug can be used? a) Isoniazid + Streptomycin b) Rifampicin + Isoniazid c) Rifampicin + Ethambutol d) Streptomycin + Ethambutol

22. A patient suffering from AIDS is on Zidovudine, Lamivudine and Indinavir therapy. He develops Pulmonary tuberculosis for which treatment is started. Which of the following should be avoided in him? a) INH b) Ethambutol c) Pyrazinamide d) Rifampicin

23. A patient suffering from AIDS is on Zidovudine, Lamivudine and Indinavir therapy. He develops Pulmonary tuberculosis for which treatment is started. Which of the following should be avoided in him? a) INH b) Ethambutol c) Pyrazinamide d) Rifampicin Rifampicin is avoided in patients on antiretroviral therapy (ART), particularly those using protease inhibitors (PIs) or non-nucleoside reverse transcriptase inhibitors (NNRTIs), because rifampicin induces liver enzymes, reducing ART drug levels, potentially leading to suboptimal viral suppression and resistance.

24. Which of the following should be avoided in a pregnant female? a) Isoniazid b) Streptomycin c) Pyrazinamide d) Rifampicin

25. Which of the following should be avoided in a pregnant female? a) Isoniazid b) Streptomycin c) Pyrazinamide d) Rifampicin Streptomycin is avoided in pregnant women because it is ototoxic and can cause hearing loss in the fetus. It can also potentially lead to kidney damage.

26. Which of the following is side effects of cyclocerine ? A. Photosenstivity B. Seizures and psychosis C. Thrombocytopenia D. Nausea and vomiting

27. Which of the following is side effects of cyclocerine ? A. Photosenstivity B. Seizures and psychosis C. Thrombocytopenia D. Nausea and vomiting Cycloserine inhibits two enzymes involved in bacterial cell wall synthesis: D-alanine racemase and D-alanine-D-alanine ligase, disrupting peptidoglycan formation in Mycobacterium tuberculosis. Side effects include CNS toxicity (e.g., seizures, psychosis), peripheral neuropathy, headache, nausea, and rare hepatotoxicity, requiring careful monitoring during treatment.