Anti Tuberculosis

Question 1

Medium for TB culture

Answer 1

Lowenstein Jensen

Question 2

TB characteristic in colony

Answer 2

Serpentine growth

Question 3

TB Drugs

Answer 3

Isoniazid
Rifampicin
Pyrazinamide
Ethambutol
Streptomycin

Question 4

Isonicotinic acid hydrazide

Answer 4

Isoniazid

Question 5

Inhibits mycolic acid

Inhibits the enzyme desaturase (bacilli cell wall synthesis)

Answer 5

Isoniazid

Question 6

Isoniazid absorption impaired by

Answer 6

intake of antacid

Question 7

Isoniazid is an enzyme

Answer 7

inhibitor

Question 8

Isonizid inhibits CYP450 and increases concentration of

Answer 8

Phenytoin
Warfarin
Benzodiazepine

Question 9

Isoniazid adverse effects

Answer 9

SLE
Hepatotoxicity
Neurotoxicity (Peripheral neuritis)
Rashes
Crosses placenta and can cause peripheral neuritis

Question 10

Antidote for Isoniazid-induced peripheral neuritis

Answer 10

Vitamin B6 Pyridoxine

Question 11

Metabolites of isoniazid

Answer 11

Acetylisoniazid
Acetylhydrazine
Hydrazine

Question 12

Most active agent of the TB regimen

Answer 12

Rifampin

Question 13

Obtained from streptomyces mediterranei
Inhibits B subunit of DNA depedent RNA polymerase

Inhibits RNA/protein synthesis

Answer 13

Rifampin

Question 14

Rifampin is an enzyme

Answer 14

inducer of CYP450

Question 15

Used in meningococci, leprosy, Legionnaire’s disease

Answer 15

Rifampin/Rifampicin

Question 16

Causes red orange urine and tears

Answer 16

Rifampin

Question 17

Rifampicin SE

Answer 17

Red orange urine and tears

Rash, fever, flulike symptoms

Question 18

Used for prophylaxis of meningococcemia

Answer 18

Rifampicin

Question 19

Firstl line for short term TB treatment

Answer 19

Pyrazinamide

Pyrazinecarboxamide

Question 20

Adverse effect of Pyrazinamide

Answer 20

Hepatotoxicity

Question 21

Must be enzymatically hydrolyzed to pyrazinoic acid its active form

Answer 21

Pyrazinamide

Question 22

Unknown mechanism
Bacteriostatic

Inhibition of mycobaterial arabinosyl transferase enzyme

Inhibits arabinoglycan (important for bacilli cell wall synthesis)

Answer 22

Ethambutol

Question 23

Ethambutol can cause

Answer 23

Optic neuritis and

Loss of ability to discriminate between red and green

Question 24

Structural analog of isoniazid

Answer 24

Ethionamide

Question 25

Used in treatment of isoniazid resistant TB

Answer 25

Ethionamide

Question 26

Ethionamide AE

Answer 26

Gastric irritation Helatotoxicity Peripheral neuropathy Optic neuritis

Question 27

2nd line anti-TB drug that is a structural analog of isoniazid

Answer 27

Ethionamide

Question 28

Rifampicin Major SE

Answer 28

Red orange secretion and urine

Question 29

Isoniazid Major SE

Answer 29

Peripheral neuritis

Question 30

Pyrazinamide Major SE

Answer 30

Inc uric acid | Hepatotoxicity

Question 31

Ethambutol Major SE

Answer 31

Visual problems

Question 32

Streptomycin Major SE

Answer 32

Ototoxic

Question 33

Only aminoglycoside used for TB First antibiotic effective in the treatment of tuberculosis Bactericidal for actively dividing intracellular mycobacteria

Answer 33

Streptomycin

Question 34

Streptomycin AE

Answer 34

Ototoxicity | Nephrotoxicity

Question 35

Drugs used in the treatment of Leprosy

Answer 35

Dapsone Clofazimine Rifampicin

Question 36

PABA antagonist | Sulfonamide

Answer 36

Dapsone

Question 37

Dapsone SE

Answer 37

GI irritation Methemoglobinemia Hemolytic anemia (G6PD deficiency)

Question 38

Basic red dye used in the treatment of leprosy including dapsone-resistant forms

Answer 38

Clofazimine

Question 39

All first line TB meds are bactericidal EXCEPT

Answer 39

Ethambutol (Bacteriostatic)

Question 40

Only IV antiTB first line drug

Answer 40

Streptomycin

Question 41

Resistance to more than one drug but not the combination isoniazid and rifampicin

Answer 41

Poly-resistant

Question 42

Second line anti TB drugs

Answer 42

``` Ethionamide* Prothionamide Cycloserine Fluoroquinolone* Terizadone Para-aminosalicylic acid Thiacetazone Clofazimine Amikacin* Kanamycin* Capreomycin * ```

Question 43

Nove generation anti TB

Answer 43

Delamanid Pretomanid Bedaquiline

Question 44

Enzyme required for cel wall synthesis inhibited by isoniazid

Answer 44

Desaturase

Question 45

Isoniazid side effect

Answer 45

Iron accumulates in mitochondria (Sideroblastic anemia) Neuritis/neuropathy (Vit B6 Pyridoxine supplement) Hepatitis Psychosis and other CNS symptoms Drug induced Lupus

Question 46

``` Arthritis Rash Photosensitivity Fever Myalgia ```

Answer 46

Drug induced Lupus

Question 47

Drug induced lupus associated with antibodies

Answer 47

Antihistone antibody

Question 48

Drug Induced Lupus

Answer 48

HIP POP MCS ``` Hydralazine Isoniazid Procainamide Phenytoin Oxcarbazepine Propafone Minocyclin Carbamazepine Sulfonamide ```

Question 49

Ethambutol dose

Answer 49

15mg/kg/day

Question 50

Ethambutol SE

Answer 50

Retrobulbar optic neuritis Optic neuritis Barrel vision Red oranfe Blindness

Question 51

Ethambutol dose related optic neuro

Answer 51

15 mg 1% optic neuropathy 25 mg 5% optic neuropathy 50 mg 15% optic neuropathy Onset in 1 month Recovery on discontinuing of drug; rarely permanent

Question 52

Pyrazinamide Mechanism

Answer 52

Pyrazinamidase deaminates pyrazinamide into pyrazinoic acid killing mycobacteria and inhibits Fas (inhibit growth mycobacteria)

Question 53

Nicotinamide analog Bactericidal for actively dividing intracellular mycobacteria Main effect occur in a few months

Answer 53

Pyrazinamide

Question 54

Binds 30s ribosomes False pair of codon:anticodone False reading of genetic cord Inhibit protein synthesis

Answer 54

Streptomycine

Question 55

Derived from nitro-dihydroimidazooxazole class of compounds that inhibits mycolic acid synthesis of bacterial cell wall Treatment of MDRTB and extensively drug resistant TB

Answer 55

Delamanid

Question 56

Treatment of multidrugresistant TB Inhibits mycobacterial adenosine triphosphate synthase

Answer 56

Bedaquiline