1. A man presented with fever wt. loss & cough.Mantoux reads an induration of 17× 19 mm sputum cytology is –ve for AFB.Most likely diagnosis is: a. Pul T.B. b. fungal infection c. viral infection d. pneumonia 2. Tuberculous pleural effusion is characterised by all of the following features except effusion: a haemorrhagic effusion b pleural fluid LDH > 60% that of serum LDH c increased deaminase d increased mesothelial cells 3.Gold standard for the diagnosis of tb is a. cxr b. culture c. sputum afb d.bactec TB 460 4. positive mantoux test indicates…. a. induration of 6mm or more b. induration of 10mm or more c. induration of 15mm or more d. induration of 20mm or more 5. Type IV hypersensitivity to Mycobacterium tuberculosis antigen may manifest as: a. Iridocyclitis. b. Polyarteritis nodosa. c. Phlyctenular conjunctivitis. d. Giant cell arteritis.
6. The standard drug regimens recommonded for tuberculosis are a) ( INH +RCIN+ ETB) 2 months + (INH +RCIN) 7 months b) INH +RCIN+ ETB X 9 months c) (INH +RCIN + PZA + ETB) 2 months+4 months (INH + RCIN) d) RCIN+ ETB X 12months 8. Regarding TB in HIV, which statement is not true: a) b) c) d)
Reduced smear positivity seen with pulmonary TB Less cavitation and more dissentmination More extra pulmonary infection Adverse drug reactions to anti- tubercular drugs are least seen
9. Regarding TB lymphadenitis, which statement is not true: a) Paradoxical enlargement of lymph nodes, suppuration can occur during or after treatment b) Constitutional features are absent in 50% of the patients c) Supraclavicular lymphadenopathy is from mediastinal spread d) Tuberculin test is negative 10. About ethambutol which statement is not true: a) b) c) d)
It is bacteriostatic It is contraindicated below age 6 years It has no hepatotoxicity It is nephrotoxic
11 . Match the following: Diseases associated with pulmonary TB
Treatment with anti-TB drugs
1. Renal failure
a. Frequent monitoring of LFT needed
2. Diabetes mellitus
b. MDR seen paradoxical response or immune reconstitution phenomenon to ATT seen
3. Postrenal transplant
c. Dose of OHA to be increased due to
patient
interaction with rifampicin
4. Preexisting liver disease
d. Rifampicin avoided, it increases clearance of cyclosporin
5. HIV infection
e. Dosage to adjust for streptomycin ethambutol and isoniazid
12. . Match the following anti-TB drugs with their side effects; Anti- TB drug
Side effect
1. Isonex
a. Drug interacts on with anti-retroviral drugs
2. Rifampicin
b. Ance
3. Pyrazinamide
c. Photosensitivity and hyperuricemia
4. Ethambutol
d. Ataxia
5. INJ. streptomycin
e. Optic neuritis
6. PAS
f. Convusions
7.Cyclosporine
g. Neuromuscular blockade
8. Amikacin
h.Dysgeusia
9.Ethionamide
i.Hypothyroidism
13. Highest priority of TB central programme is: a) b) c) d)
DOTS therapy Supplying free therapy to TB patients Educate public above TB awareness Good quality diagnosis with sputum smear microscopy to identify infectious cases 14. During adequate treatment of tuberculosis, increase or worsening of lesion occurs due to: a) b) c) d)
It is an early phenomenon of unknown etiology Overdosage of anti- TB drugs A feature commonly seen with DOTS therapy It is immunologically mediated complications of the disease
15. Steroids are not indicated in which tuberculosis a) b) c) d)
HIV with pulmonary TB Miliary TB Endobronchial TB TB meningitis
16. Miliary TB is caused by a) Hematogenous spread from a primary focus b) Bronchogenic spread c) Contiguity from tuberculous focus d) Reactivation of healed focus 17. A positive tuberculin test indicates a) Strong immunity b) Exposure to tuberculous infection c) Disseminated TB e) Primary complex 18. Chemoprophylaxis in TB is given to a) b) c) d)
Uninfected person, with risk Tuberculosis affected patients Extrapulmonary tuberculosis Treatment of failure cases
19. Reinfection TB is almost exclusively a disease of the : a.Lung b.Bones c.Joints d.brain
20. Following are the components of mycobacterium TB except…. a) b) c)
21. National T.B control program is supervised by… a) National TB institute, Banglore b) TB Research centre, Chennai c) TB Association of INDIA d) Central government of INDIA 22. Following diseases predispose to TB except… a) DM b) Pregnancy c) Silicosis d) HIV 23. Cold abscess of wall is usually due to TB of ….. a) ribs b) pleura c) intercostals muscle d) spine 24. A granuloma defined as a group of activated epithelioid macrophages surrounded by a cuff of lymphocytes can be seen in the lung in all conditions, EXCEPT: a. Sarcoidosis b. Berylliosis c. Tuberculosis d. Asbestosis
25. Ghon’s focus can be appreciated in: a. Primary tuberculosis b. Post primary tuberculosis c. Miliary tuberculosis d. Progressive primary tuberculosis
26. Cerebral tuberculosis focus is called a) Assman’s b) Simmons c) Rich’s d) Wigard’s 27. All of the following are seriously ill TB patients except: a) Pericardial b) pleural effusion c) Peritoneal d) TB osteomyelitis of long bones
28. All the following second line TB drugs are bacteriocidal except: a) Capreomycin b) Cycloserine c) Kanamycin d) Thiacetazone 29. Time interval for occurrence of genitourinary TB after primary infection is: a) 1-2 yrs b) 5-15 yrs c) 20-30 yrs d) >50 yrs 30. Live TB bacteria is identified by: a) Sputum smear b) BACTEC 460 c) PCR d) ELISA 31. Wigard’s focus is infection of TB of: a) Brain b) Hilar Lymph node c) Eye d) Endothelium
32. Treatment default is for : a) >1 month b) >2 months c) >3months d) >4 months 33. Class IV DOTS regimen is for : a) Relapse b) MDR c) Chronic cases d) HIV patients 34. A chronic case of TB is diagnosed when: a) Sputum positive after 5 months of ATT b) Sputum positive after retreatment for treatment failure c) Patient who has sequelae and TB focus after ATT d) Immunosuppressed patient with positive sputum 35. A Class I DOTS patient after 3 months of ATT was subjected to sputum examination was found to be positive then you will: a) Diagnose chronic TB b) Diagnose MDR TB c) Continue ATT for 1 more month and repeat sputum examination d) Diagnose treatment failure
36. Which among the following mycobacteria does not produce pigment when grown In light or dark? a. b. c. d.
M. avium intracellulare complex M. xenopi M. scrofulaceum M.marinum
37. For extrapulmonary TB pt, sputum should be examined if she/he has cough for a. 1 wk b. 2 wk c. 3 wk000000000000 d. any duration
38. Counter stain used for ZN staining is: a. carbol fuschin b. methylene blue c. phenopthalein d. phenol
39. Any TB pt who is smear positive at 5 months or more after starting treatment is a. relapse b. failure c. treatment after default d. new case
40. Miliary TB spreads by which route? a. inhalation b. lympho-haematogenous c. Cartilagenous d. direct contagious
41 Occupational disease a/w TB is
a. Asbestosis b. silicosis c. berylosis d. bagassosis
42 Following is the part of lymph node TB a. lupus vulgaris b. scrofuloderma c. lichen scrofulosorum d. erythma nodosum
43. Following drug is contraindicated in pregnancy a. isoniazide b. rifampicin c. pyrazinamide d. streptomycin
44. MDR TB is a. resistance to H&R b. resistance to H R Z E c. resistance to H Z d. resistance to H R E
45. TRC is situated at a. Delhi b. Banglore c. Chennai d. Kolkata
46. M. tuberculosis complex includes all except: a. M. bovis b. M. africanum c. M. microti d. M. avium intracellulare
47. Ghon’s focus is seen in a. liver b. lung c. spleen d. brain 48. what specimen is given to diagnose Pulmonary TB… a. Blood b. Transbronchial lavage c. sputum d. Transbronchial needle aspiration 49. BCG should be given at…. a. 1 wk after birth b. at birth c. at 6wks of birth d. at 6 months 50. what is prevalence and incidence rate of TB infection…. a. 10 % & 10% b. 20% & 5% c. 30% & 4%
d. 5% & 2% 51. what is prevalence and incidence rate of TB disease…… a. 10 % & 5% b. 10% & 1% c. 1-2% &1.5% d. 3% & 2% 52. what is mortality rate of Pulmonary TB…in India… a. 1pt per day b. 1pt per month c. 1 pt per hour d. 1 pt per min 53. Side effect of Rifampicin is… a. Orange discolouration of urine b. Nephrotoxicity c. Ototoxicity d. Ocular toxicity 54. Most common drug developing resistance amongst TB is… a. Rifampicin b. Pyrazinamide c. INH d. Streptomycin 55. Drug contraindicated in children below 6 years is… a. Rifampicin b. INH c. Ethambutol d. Pyrazinamide
