Tuberculosis Flashcards by Josh Datnow

Q

The following agents are used in the treatment of XDR-TB (Extreme drug resistance)
a. ethambutol

A

A. True, resistance to isoniazid, rifampicin and fluoroquinolone (floxacin)

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

The following agents are used in the treatment of XDR-TB (Extreme drug resistance)
b. isoniazid

A

B. False, resistance to isoniazid, rifampicin and fluoroquinolone (floxacin)

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

The following agents are used in the treatment of XDR-TB (Extreme drug resistance)
c. rifampicin

A

C. False, resistance to isoniazid, rifampicin and fluoroquinolone (floxacin)

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

The following agents are used in the treatment of XDR-TB (Extreme drug resistance)
d. pyrazinamide

A

D. True, resistance to isoniazid, rifampicin and fluoroquinolone (floxacin)

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

The following agents are used in the treatment of XDR-TB (Extreme drug resistance)
e. streptomycin

A

E. True

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Agents used in the management of Mycobacteria tuberculosis

a. isoniazid causes peripheral neuropathy as an adverse effect

A

A. True, hepatitis and peripheral neuropathy

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Agents used in the management of Mycobacteria tuberculosis

b. rifampicin inhibits cell wall synthesis

A

B. False, rifampicin inhibits RNA synthesis

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Agents used in the management of Mycobacteria tuberculosis

c. ethambutol causes gout

A

C. True, ethambutol and pyrazinamide cause hyperuriceamia which can lead to gout

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Agents used in the management of Mycobacteria tuberculosis

d. streptomycin is safe to use during pregnancy

A

D. False. Teratogenic

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Agents used in the management of Mycobacteria tuberculosis

e. pyrazinamide is hepatotoxic

A

E. True, pyrazinamide, isoniazid and rifampicin are hepatotoxic

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

In the treatment of tuberculosis, Isoniazid

a. is activated by catalase peroxidase (KatG)

A

A. True, isoniazid is a pro drug, activated by mycobacterial KatG

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

In the treatment of tuberculosis, Isoniazid

b. stimulates mycobacterial mycolic acid synthesis

A

B. False. Inhibits mycobacterial mycolic acid synthesis

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

In the treatment of tuberculosis, Isoniazid

c. is activated against intracellular mycobacteria

A

C. True, intra and extracellular

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

In the treatment of tuberculosis, Isoniazid

d. -induced peripheral neuropathy is treated with pyridoxine

A

D. True

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

In the treatment of tuberculosis, Isoniazid

e. induces cytochrome P450 enzymes

A

E. False. Inhibits cytochrome P450 enzymes

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

In the treatment of tuberculosis, rifampicin

a. inhibits mycobacterial RNA synthesis

A

A. True.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

In the treatment of tuberculosis, rifampicin

b. causes contraceptive failure in women taking the combined oral contraceptive pill

A

B. True, rifampicin induces CYP450 enzymes. This will result in decreased concentrations of the combined oral contraceptive

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

In the treatment of tuberculosis, rifampicin

c. inhibits the metabolism of warfarin

A

C. False, induces CYP450 enzymes increased metabolism of warfarin

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

In the treatment of tuberculosis, rifampicin

d. is bacteriostatic

A

D. False, only ethambutol is bacteriostatic

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

In the treatment of tuberculosis, rifampicin

e. causes an orange discolouration to body fluids

A

E. True

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Rifampicin

a. inhibits cytochrome P450 enzymes

A

A. False, induces

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Rifampicin

b. is used as an alternative to ciprofloxacin for prophylaxis against meningococcal infections

A

B. True.

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Rifampicin

c. causes hepatotoxicity

A

C. True, pyrazinamide, isoniazid and rifampicin are hepatotoxic

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

Q

Rifampicin

d. is used in the treatment of tuberculosis during pregnancy

A

D. True. During pregnancy give standard 6 month regiment

How well did you know this?

1

Not at all

2

3

4

5

Perfectly

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

The drug is correctly paired with its mechanism of action | a. isoniazid - inhibits mycolic acid synthesis

a. True

The drug is correctly paired with its mechanism of action | b. ethambutol - inhibits DNA gyrase

b. False, inhibits formation of mycobacterial cell wall by inhibiting arabinosyl transferase

The drug is correctly paired with its mechanism of action | c. rifampicin - inhibits DNA-dependant RNA polymerase

c. True False, inhibits cell wall synthesis

5. In the treatment of Mycobacterium tuberculosis infections | a. ethambutol causes hypouricaemia as an adverse effect

a. False, hyperuricaemia

In the treatment of Mycobacterium tuberculosis infections | b. the metabolism of isoniazid is dependent on the acetylator status of the patient

b. True

In the treatment of Mycobacterium tuberculosis infections | c. when administered concurrently, rifampicin increases the plasma concentration of oral contraceptives

c. False, induces p450 enzymes

In the treatment of Mycobacterium tuberculosis infections | d. pyrazinamide inhibits RNA synthesis

d. False, cell well synthesis