Tuberculosis Flashcards
The following agents are used in the treatment of XDR-TB (Extreme drug resistance)
a. ethambutol
A. True, resistance to isoniazid, rifampicin and fluoroquinolone (floxacin)
The following agents are used in the treatment of XDR-TB (Extreme drug resistance)
b. isoniazid
B. False, resistance to isoniazid, rifampicin and fluoroquinolone (floxacin)
The following agents are used in the treatment of XDR-TB (Extreme drug resistance)
c. rifampicin
C. False, resistance to isoniazid, rifampicin and fluoroquinolone (floxacin)
The following agents are used in the treatment of XDR-TB (Extreme drug resistance)
d. pyrazinamide
D. True, resistance to isoniazid, rifampicin and fluoroquinolone (floxacin)
The following agents are used in the treatment of XDR-TB (Extreme drug resistance)
e. streptomycin
E. True
Agents used in the management of Mycobacteria tuberculosis
a. isoniazid causes peripheral neuropathy as an adverse effect
A. True, hepatitis and peripheral neuropathy
Agents used in the management of Mycobacteria tuberculosis
b. rifampicin inhibits cell wall synthesis
B. False, rifampicin inhibits RNA synthesis
Agents used in the management of Mycobacteria tuberculosis
c. ethambutol causes gout
C. True, ethambutol and pyrazinamide cause hyperuriceamia which can lead to gout
Agents used in the management of Mycobacteria tuberculosis
d. streptomycin is safe to use during pregnancy
D. False. Teratogenic
Agents used in the management of Mycobacteria tuberculosis
e. pyrazinamide is hepatotoxic
E. True, pyrazinamide, isoniazid and rifampicin are hepatotoxic
In the treatment of tuberculosis, Isoniazid
a. is activated by catalase peroxidase (KatG)
A. True, isoniazid is a pro drug, activated by mycobacterial KatG
In the treatment of tuberculosis, Isoniazid
b. stimulates mycobacterial mycolic acid synthesis
B. False. Inhibits mycobacterial mycolic acid synthesis
In the treatment of tuberculosis, Isoniazid
c. is activated against intracellular mycobacteria
C. True, intra and extracellular
In the treatment of tuberculosis, Isoniazid
d. -induced peripheral neuropathy is treated with pyridoxine
D. True
In the treatment of tuberculosis, Isoniazid
e. induces cytochrome P450 enzymes
E. False. Inhibits cytochrome P450 enzymes
In the treatment of tuberculosis, rifampicin
a. inhibits mycobacterial RNA synthesis
A. True.
In the treatment of tuberculosis, rifampicin
b. causes contraceptive failure in women taking the combined oral contraceptive pill
B. True, rifampicin induces CYP450 enzymes. This will result in decreased concentrations of the combined oral contraceptive
In the treatment of tuberculosis, rifampicin
c. inhibits the metabolism of warfarin
C. False, induces CYP450 enzymes increased metabolism of warfarin
In the treatment of tuberculosis, rifampicin
d. is bacteriostatic
D. False, only ethambutol is bacteriostatic
In the treatment of tuberculosis, rifampicin
e. causes an orange discolouration to body fluids
E. True
Rifampicin
a. inhibits cytochrome P450 enzymes
A. False, induces
Rifampicin
b. is used as an alternative to ciprofloxacin for prophylaxis against meningococcal infections
B. True.
Rifampicin
c. causes hepatotoxicity
C. True, pyrazinamide, isoniazid and rifampicin are hepatotoxic
Rifampicin
d. is used in the treatment of tuberculosis during pregnancy
D. True. During pregnancy give standard 6 month regiment
Rifampicin
e. enhances mycobacterial RNA synthesis
E. False. Inhibit RNA synthesis
Antimycobacterial agents
a. isoniazid causes peripheral neuropathy
A. True, causes peripheral neuropathy and hepatitis
Antimycobacterial agents
b. pyrazinamide decreases serum uric acid levels
B. False. Pyrazinamide and ethambutol cause hyperuricaemia
Antimycobacterial agents
c. ethambutol-induced optic neuritis is reversible with discontinuation of the drug
C. True, stop immediately
Antimycobacterial agents
d. pyrazinamide is safe to use in patients with advanced acute liver failure
D. False, hepatotoxic, use ethambutol
Antimycobacterial agents
e. ethambutol increases the risk of acute gout
E. True. Causes hyperuricaemia
a. multidrug resistant tuberculosis is characterized by resistance to rifampicin, isoniazid and pyrazinamide
A. False, rifampicin and isoniazid
b. ethambutol is used for prophylaxis against tuberculosis in individuals with a positive TB contact
B. False, isoniazid
c. ethambutol is hepatotoxic
C. False, ocular toxicity and hyperuricaemia
d. there are no effective drugs against XDR tuberculosis
D. False, XDR is resistance to isoniazid, rifampicin and fluoroquinolone (floxacin). Thus, can treat with other agents
e. isoniazid causes peripheral neuropathy
E. True, and hepatitis
Rifampicin
a. induces cytochrome P450 enzymes
A. True
Rifampicin
b. is effective against resistant staphylococcal infections
B. True, clinical uses include: Mycobacterium Tuberculosis, Leprosy, brucellosis, resistant staphylococcal infections
Rifampicin
c. enhances the antihypertensive effect of verapamil
C. False, induced P450 will increase clearance thus decreasing the effects of verapamil
Rifampicin
d. is used in the treatment of MDR tuberculosis
D. False. MDR TB is classified as resistance to isoniazid and rifampicin
Rifampicin
e. enhances mycobacterial RNA synthesis
E. False, Inhibits RNA synthesis
Antimycobacterial agents
a. pyrazinamide is preferred to isoniazid as prophylaxis in patients at high risk of contracting tuberculosis
A. False, isoniazid is given as TB prophylaxis
Antimycobacterial agents
b. pyrazinamide increases serum uric acid levels
B. True
Antimycobacterial agents
c. ethambutol causes red/green colour blindness
True
Antimycobacterial agents
d. pyrazinamide is hepatotoxic
D. True, pyrazinamide, isoniazid and rifampicin are hepatotoxic
Antimycobacterial agents
e. ethambutol decreases serum uric acid levels
E. False, ethambutol and pyrazinamide causes hyperuricaemia
rifampicin inhibits cytochrome P450 enzymes
False, induces
ethambutol is hepatotoxic
False. Ocular toxic
isoniazid inhibits protein synthesis
False. Cell wall synthesis
rifampicin decreases the clinical effectiveness of warfarin
True , P450s
pyridoxine is used to treat isoniazid-induced peripheral neuropathy
True
ethambutol causes an orange discolouration of urine
False. Rifampicin
ethambutol is given as prophylaxis to TB close contacts
False. Isoniazid
a. isoniazid causes peripheral neuropathy as an adverse effect
True,
b. ethambutol inhibits mycobacterial RNA polymerase
True. It diffuses into the mycobacteria and appears to suppress multiplication by interfering with RNA synthesis.
c. pyrazinamide decreases serum uric acid levels
False, increases
d. pyrazinamide is hepatotoxic
True
e.rifampicin discolours body secretions to a red-orange colour
True
Match the TB drugs with its side-effect Rifampicin Peripheral neuropathy Urine discolouration (red-orange) Blurred vision Joint pain
Urine discolouration (red-orange)
Match the TB drugs with its side-effect Isoniazid Peripheral neuropathy Urine discolouration (red-orange) Blurred vision Joint pain
Peripheral neuropathy
Match the TB drugs with its side-effect Pyrazinamide Peripheral neuropathy Urine discolouration (red-orange) Blurred vision Joint pain
Joint pain
Match the TB drugs with its side-effect ethmbutol Peripheral neuropathy Urine discolouration (red-orange) Blurred vision Joint pain
Blurred vision
A 38 year old patient presents to the TB clinic complaining of blurred vision. Which agent from his first line drug regimen is responsible for the ocular effects he is experiencing?
ethambutol
