MCQ’s in T.

B
Prepared by : Ahmad Kadhum Al-Jalehawi

Ahmad K. Al-J
1- TB is an infection caused by :
a- Mycobacterium tuberculosis
Never stop learning, because life
b- Mycobacterium bovi
never stops teaching
c- Trichomoniasissis
d- Viral infection
2- TB causes :
a- Silent ( latent ) infection
b- Progressive ( Active) infection
c- Both
d- HIV
3- TB transmitted via:
a- Cough only
b- Any action that makes the bacteria carried through air
c- Fecal contamination
d- Skin contact
e- A&B
4- ----- is the most important risk factor for progression to Active TB.
a- Meningitis
b- HIV infection
c- COPD
d- Asthma
5- Patient who has HIV are ------ times more likely to have Active TB than HIV negative individuals.
a- 10
b- 100
c- 1000
d- 5
6- -----% of patients with TB have no further clinical manifestation rather than the primary site.
a- 90%
b- 5%
c- 40%
d- 10%
7- ------% of patient with TB has progressive disease disseminated to other parts rather than primary
infection site.
a- 5%
b- 90%
c- 10%
d- 50%
8- The usual primary site of infection in TB is:
a- Lower lobe of lung
b- Upper lobe of the lung
c- CNS
d- GIT
9- Massive inoculum of Mycobacterium introduced into the bloodstream, causing widely
disseminated disease and granuloma formation it known as ------- .
a- Meningitis
b- Miliary TB
c- Septicemia
d- Pulmonary TB
10- Which one of the followings is/are a symptom for TB infection:
a- Night sweating
b- Weight loss
c- Fever
d- Cough
e- Hemoptysis
f- All of above
11- Which symptom of TB infection present late in disease course but may also present earlier :
a- Cough
b- Night sweating
c- Hemoptysis
d- Fatigue
12- The symptoms of Extra pulmonary TB are:
a- Depends on the affected organ
b- Decline in organ function
c- Fever
d- Non of above
e- All of above
13- In HIV patient with TB, which one is correct:
a- The patient may have atypical symptoms
b- Fever may not present
c- Skin test might be negative
d- High rate of extrapulmonary TB
e- High rate of progressive primary disease
f- All are correct
14- TB in elder patient is easily confused with another respiratory disease,because :
a- Less possibility of positive skin test
b- Less possibility of symptoms (fever, night sweating,..)
c- Usually have COPD
d- High rate of drug interactions
e- A&B
15- The most widely screen test for TB is:
a- Widal test
b- Acid fast test
c- Tuberculin skin test
d- Chest X-ray
16- In order to confirm active TB infection its recommended to isolate M. tuberculosis :
a- By daily sputum collection over consecutive 3 days
b- By daily sputum collection over consecutive 7 days
c- By sputum collection between day and another for 3 days
 d- By skin tuberculin test
17- Measure of blood ------ of TB patient, which released against the TB antigen, provide a quick and
specific result in M. tuberculosis.
a- Interferon- γ
b- TNF-a
c- IL-6
d- Acid-fastast test
18- Minimum number of drugs in the treatment of TB is……….:
a- Three
b- Four
c- Two
d- One
19- Usual number of drug treatments of TB is :
a- Three or four
b- five
c- Two
d- One
20- A cost-effective method of administering medications to TB for ensuring that patient completes
the treatment is ------------- which consider the standard of care.
a- Inpatientent administration
b- DOT directly observed therapy
c- Time-based therapy
d- Intravenous pump administration
21- The usual treatment duration of TB is not less than ----------- while it is ---------- for
multidrug resistance TB(MDR-TB).
a- 6 months, 18-24 months
b- 4 months , 6-9 months
c- 2 months, 12 months
d- 6 months , 6-9 months
22- The treatment of TB includes:
a- Use of non-pharmacological treatment only
b- Use of combination medicines
c- Surgery might be needed to remove destroyed tissues
d- radiation treatment might be helpful
e- B&C
23- Generally ------ is preferred for 9 months in latent TB.
a- INH (isoniazid )
b- Rifampin
c- Ethambutol
d- Pyrazinamide
24- In latent infection TB .For patient who can not tolerate INH ( isoniazid )or in case of suspected
resistance ,------- is used for 4 months.
a- INH (isoniazid )
b- Rifampin
c- Ethambutol
d- Pyrazinamide
25- Patient on rifampin with high drug interactions,----------- could be used as an alternative to it.
a- Rifabutin
b- INH
c- Pyrazinamide
d- Ethambutol
26- In latent infection :
a- There is no need for treatment
b- The chemoprophylaxis should be initiated to decrease risk of progression to active disease
c- Pregnant women should not receive treatment
d- Treat the patient for 2 months only
27- -------- patient taking INH for TB should receive Vitamin B6 ( pyridoxine) 10-50mg/day to reduce
the incidence of central nervous system (CNS) effects or peripheral neuropathies.
a- Pregnant women
b- Alcoholic
c- Poor diet
d- All of above
28- Choose the right treatment regimen for TB:
a- INH+Rifampin+pyrazinamide+ethambutol ( 2 months) followed by INH+rifampin (4months)
b- INH+rifampin (4months) followed by INH+Rifampin+pyrazinamide+ethambutol ( 2 months)
c- INH+Rifampin+pyrazinamide+ethambutol ( 4 months) followed by INH+rifampin (2 months)
d- INH+Rifampin+pyrazinamide+ethambutol ( 6 months)
29- In what situations the duration of the treatment is 9 months and at least 6 months from smear
conversion and negative culture?
a- Patient who slow respons
b- Patients who still culture-positive after 2 month of treatment
c- Patient with C-Xray shows cavity lesions
d- HIV-positive patient
e- All of above
30- Which one is true for resistance TB :
a- There is no standard regimen
b- Avoid the use of monotherapy or add a new drug to a failing regimen
c- The patient should receive new drugs which not has been received previously
d- All of above are true
31- When the resistance TB infection is suspected ?
a- Patient who infected from to a MDR-TB patient
b- Patient with sputum smear positive after 2 month of treatment
c- Patient with positive culture after 2-4 months of treatment
d- Homeless HIV patient
e- IV drug abusers
f- Received TB medication previously
g- Living in area with known prevalence of resistance cases
h- All of above
32- Patients with CNS or bone TB treated for ------
a- 4months
b- 6months
c- 2months
 d- 9-12 months
33- Which one of the following could be used for CNS TB because it penetrates BBB?
a- INH
b- Pyrazinamide
c- Ethionamide
d- Cycloserin
e- All of above
34- Extrapulmonary TB of the soft tissues can be treated with conventional regimens.
a- True
b- False
35- TB in children may be treated with regimens similar to those used in adults
a- True
b- False
36- ------------- is used for pregnant women with TB may cause birth defect including reduction of limbs
and CNS lesions.
a- INH
b- Rifampin
c- Streptomycin
d- Cycloserin
37- ---------- is not recommended for pregnant women with TB as it is associated with premature
delivery and down syndrome.
a- Streptomycin
b- Ethionamide
c- INH
d- Rifampin
38- The treatment of TB in pregnant women include :
a- INH+rifampin+ ethambutol for 9 months
b- INH + Rifampin+ Ethionamide for 9 months
c- Streptomycin +INH+ Rifampin for 4 months
d- INH+rifampin+ ethambutol for 6 months
39- ----------- has been associated with hearing impairment in the newborns and deafness so it is
reserved for critical situations where alternatives do not exist.
a- INH
b- Rifampin
c- Streptomycin
d- Cycloserin
40- Cycloserin is recommended to be used in pregnancy with TB because of high cure rate.
a- True
b- False
41- In patient with TB and Renal failure which one of medications doesn’t require dose adjustment ?
a- INH+ Rifampin
b- Pyrazinamide + ethambutol
c- INH + rifampin
d- INH + ethambutol
42- In patient with TB and Renal failure which one of medications require dose adjustment from daily
dose to 3 times/week ?
 a- INH+ Rifampin
b- Pyrazinamide + ethambutol
c- INH + rifampin
d- INH + ethambutol
43- The most serious problem with TB treatment is ------------- which effectively managed by DOT.
a- Non-adherence
b- Resistance
c- Availability of medicines
d- Side effects
44- In evaluation of TB treatment outcomes , patient who Acid fast bacilli (AFB) smear is positive should
have sample sent every ------ weeks until TWO consecutive smears are negative.
a- 2-3 weeks
b- 1-4 weeks
c- 1-2 weeks
d- 3-4 weeks
45- Once patient is on the maintenance treatment of TB , patient should have ------sputum culture
till negative.
a- Monthly
b- Weekly
c- Daily
d- Twice weekly
46- On maintenance TB treatment , the negative sputum culture seen generally in --------.
a- 2-3 months
b- 1 months
c- 2 weeks
d- 4 weeks
47- Hepatotoxicity is suspected in patient taking TB medications if :
a- Transaminase exceed 5 times the upper normal limits
b- Total bilirubin exceed 3mg/dl
c- A&B
d- Non of above
48- Patients should have blood urea nitrogen, serum creatinine, aspartate transaminase or alanine
transaminase, and a complete blood count determined at baseline and periodically to assess the
toxicity with TB medications.
a- True
b- False
Answers

1- A
2- C
3- E
4- B
5- B
6- A
7- A
8- A
9- B
10- F
11- C
12- E
13- F
14- E
15- C
16- A
17- A
18- C
19- A
20- B
21- A
22- E
23- A
24- B
25- A
26- B
27- D
28- A
29- E
30- D
31- H
32- D
33- E
34- A
35- A
36- B
37- B
38- A
39- C
40- B
41- A
42- B
43- A
44- C
45- A
46- A
47- C
48- A