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Flashcards in National Health Programmes, Policies, and Legislations in India Deck (44):
1

A 25 yr old female has been diagnosed to be suffering from tuberculosis categorised as category I (Sputum +ve) case of relapse. The new treatment regimen recommended under DOTS is -

  1. 2(HRZE)3 + 5(HR)3
  2. 2(HRSZE)+ 1(HRZE)3+ 5(HRE)3
  3. 3(HRZE)+ 2(HRE)3 + 4(HR)3
  4. 3(HRSZE)3 + 1(HRZE)+ 6(HRE)3

2. 2(HRSZE)+ 1(HRZE)3+ 5(HRE)3

 

2

For sputum smear to come positive on ZN staining there should be minimum -

  1. 100 bacilli per ml sputum
  2. 1000 bacilli per ml sputum
  3. 2000 bacilli per ml sputum
  4. 10,000 bacilli per ml sputum

4. 10,000 bacilli per ml sputum

3

Which is the right number of doses of ATT for a category II patient under DOTS?

  1. IP - 24, CP - 54
  2. IP - 36, CP - 66
  3. IP - 24, CP - 48
  4. IP - 36, CP - 54

2. IP - 36, CP - 66

 

  1. Number of doses of ATT for cat I patient under DOTS - IP-24, CP -54
  2. Number of doses of ATT for cat II patient under DOTS - IP-36, CP -66
  3. Number of doses of ATT for cat IV/V patient under DOTS - IP-182, CP -546

 

4

In RNTCP the schedule for sputum examination for category I patients is -

  1. 2, 3 and 5 months
  2. 2, 4 and 6 months
  3. 1, 3 and 5 months
  4. 2, 5 and 7 months

2. 2, 4 and 6 months

5

Best indicator of trend of tuberculosis unaffected by current control measures is -

  1. Annual risk of infection
  2. Prevalence of TB infection
  3. % of primary drug resistance
  4. % of multidrug resistance

1. Annual risk of infection

ARI - Proportion of population which will be primarily infected with tuberculosis incourse of 1 year.

ARI is known as Tuberculin conversion index.

Best indicator of trend of TB unaffected by current control measures.

ARI india - 1-2%

6

Multidrug resistance in TB is defined as resistance to -

  1. Streptomycin, Rifampicin and Isoniazid
  2. Streptomycin and Rifampicin
  3. Isoniazid and Rifampicin
  4. Streptomycin and Isoniazid

3. Isoniazid and Rifampicin

7

Every TB sputum +ve patient can infect upto -

  1. 1-2 persons per year
  2. 5-6 persons per year
  3. 10-15 persons per year
  4. 100-200 persons per year

3. 10-15 persons per year

8

Under RNTCP, objective is to achieve -

  1. To achieve a cure rate of 70% and then to detect 85% of estimated cases
  2. To achieve a cure rate of 85% and then to detect 70% of estimated cases
  3. To detect 70% of estimated cases and then to achieve a cure rate of 85%
  4. To detect 85% of estimated cases and to achieve cure rate of 70%

None

Detection of > 90% of all incident cases and succussfully treat > 90% of new smear positive cases and  > 85% of all previously treated Tb patients.

9

Antitubercular drug contraindicted during pregnancy is -

  1. Isoniazid
  2. Rifampicin
  3. Streptomycin
  4. Ethambutol

3. Streptomycin

10

Under RNTCP, a patient who was intially sputum smear positive who began treatment and who remained or became smear positive again 5 months later during course of treatment is a -

  1. New case
  2. Relapse
  3. Failure case
  4. Defaulter

3. Failure case

11

Adult male patient presented in the OPD with cough and fever for 3 months and hemoptysis off and on. His sputum was positive for AFB. On probing he had already received treatment with RHZE from nearby hospital and discontinued. How will you categorise and manage the patient?

  1. Category III, Start 2(HRZ)3
  2. Category II, Start 2(HRZE)3
  3. Category I, Start 2(HRZE)3
  4. Category II, Start 2( HRZES)3

4. Category I, Start 2(HRZE)3

12

The sputum examination under DTP is done when the patient present with -

  1. Cough of 1-2 weeks duration
  2. Persistent cough of 1-2 days duration
  3. Hemoptysis
  4. Chest pain
  5. Intermittent fever

3. Hemoptysis

13

True about Revised National tuberculosis programme -

  1. Active case finding
  2. DOTS applied
  3. Treatment is given only in smear positive cases
  4. General practitioners are restricted to give the treatment
  5. It has replaced NTP

2. DOTS applied

5. It has replaced NTP

14

Which is not included in RNTCP?

  1. Active case finding
  2. Directly observed
  3. X-ray is diagnostic 
  4. Drugs given daily

1. Active case finding

3. X-ray is diagnostic

4. Drugs given daily

15

True about DOTS -

  1. Given under supervision
  2. Streptomycin always given in first 2 months
  3. Intermittent regimen are used
  4. Same regimen is given in all patient
  5. In category I - new sputum +ve cases sputum examined in 2.5 and 6 months

1. Given under supervision

3. Intermittent regimen are used

16

A pregnant female in first trimester came with sputum positive TB, treatment of choice -

  1. Start Cat I treatment immediately
  2. Start Cat II treatment immediately
  3. Start Cat III treatment immediately
  4. Delay treatment till 2nd trimester

1. Start Cat I treatment immediately

17

A person with tuberculosis on domiciliary treatment is expected to do all except -

  1. Dispose sputum safely
  2. Use separate vessels
  3. Collect drugs regularly
  4. Report to PHC if new symptoms arise

2. Use separate vessels

18

Dose of rifampicin in RNTCP is -

  1. 300 mg
  2. 450 mg
  3. 600 mg
  4. 800 mg

2. 450 mg

19

Drugs are used in AKT-4 kit for TB as -

  1. Decrease in resistance by mutation
  2. Decrease in resistance by conjugation
  3. To cure disease early
  4. None

1. Decrease in resistance by mutation

20

DOTS criteria for TB is positive if  -

  1. 1 out of 2 sputum positive
  2. 2 out of 3 sputum positive
  3. CXR positive
  4. Mantoux positive

1.1 out of 2 sputum positive

21

True about category III RNTCP is/are-

  1. Recently abolished
  2. Meant for MDR-TB treatment
  3. Given for 6 months
  4. Includes defaulters
  5. Based on sputum culture findings

1. Recently abolished

3. Given for 6 months

22

Why are TB patients are recommended a regimen of 4 drugs on first visit?

  1. To avoid emergence of persistors
  2. To avoid side effects
  3. To cure early
  4. None of the above

1.To avoid emergence of persistors

23

XDR-TB definition includes resistance to -

  1. Rifampicin
  2. Any one Fluoroquinolone
  3. INH
  4. Kanamycin
  5. Ethionamide

1. Rifampicin

2. Any one Fluoroquinolone

3.INH

4. Kanamycin

24

Under RNTCP diagnosis, TB bacilli take up AFB stain faster showing beaded appearance due to presence of  -

  1. Palmitic acid
  2. Wax-D
  3. Cord factor
  4. Mycolic acid

4. Mycolic acid

25

Who cannot supervise DOTS under RNTCP -

  1. Father
  2. Teacher
  3. Health worker
  4. Social worker

1. Father

26

Pitfalls of DOTS -

  1. High cost
  2. Destigmatization
  3. High cure rate
  4. Prevents failure and MDR

1. High cost

27

RNTCP objective for cure rate is -

  1. 70%
  2. 80%
  3. 90%
  4. 100%

3. 90%

28

Drug not included in continuation phase of category II under RNTCP -

  1. Isoniazid
  2. Rifampicin
  3. Ethambutol
  4. Pyrazinamide

4. Pyrazinamide

29

National strategic plan for TB control 2012 -2017 programme includes all except -

  1. Benefit to patients who had treatment to private hospitals
  2. Reduce default case for new case  < 10% and < 5% for reinfection of TB 
  3. Wages given to ASHA workers on completion of treatment
  4. Find TB + HIV cases

2. Reduce default case for new case  < 10% and < 5% for reinfection of TB 

30

In a suspect TB patient, 2 boxes are given for sputum sample collection, they are labelled as -

  1. a, b
  2. A, B
  3. 1, 2
  4. Y, Z

1. a, b

 

31

A patient came to a private practitioner and was diagnosed tuberculosis. Within how many days he has to inform or register to DHO?

  1. 1 day
  2. 7 days
  3. 30 days
  4. 1 year

3. 30 days

32

A 45 year old male patient comes to OPD with cough and diarrhea since last 3 weeks. On diagnosis he is found to be HIV +ve with tuberculosis. Next line of management is ?

  1. Start ATT followed by ART
  2. Start ART followed by ATT
  3. Start ATT 
  4. Start ART and then start ATT after 6-8 weeks

1. Start ATT followed by ART

33

For diagnosis of TB, sputum microscopy has -

  1. High sensitivity and high specificity
  2. High sensitivity and low specificity
  3. Low sensitivity and high specificity
  4. Low sensitivity and low specificity

3. Low sensitivity and high specificity

34

Not a component of DOTS -

  1. Political commitment
  2. Uninterrupted supply of drugs
  3. Medicine given for 1 month
  4. Accountability

3. Medicine given for 1 month

35

Objectives of RNTCP are -

  1. Detects atleast 85% of cases
  2. Achieve atleast 85% of cure rate
  3. No help from NGO
  4. Achieve atleast 90% of cure rate

4. Achieve atleast 90% of cure rate

36

Which of the following is/are true about RNTCP -

  1. TB is mandatory to notify
  2. Suspicious TB patients are screened through 2 sputum smear examinations
  3. MDR-TB is not included in RNTCP
  4. Case finding is active
  5. Cover the entire country since March 2006

1.TB is mandatory to notify

2. Suspicious TB patients are screened through 2 sputum smear examinations

3. Case finding is active

4. Cover the entire country since March 2006

37

IT based TB monitoring is known as. -

  1. Nischay
  2. Nikshay
  3. Nirbhay
  4. e-DOTS

2. Nikshay

38

Most peripheral laboratory under RNTCP is -

  1. Tuberculosis unit
  2. Peripheral reference laboratory
  3. Intermediate reference laboratory
  4. Designated microscopy unit

4. Designated microscopy unit

39

Disadvantage of INH prophylaxis are all of the following except 

  1. Costly
  2. Not effective
  3. Cannot prevent disease in infected patients
  4. Risk of hepatitis

3. Cannot prevent disease in infected patients

40

In revised national tuberculosis control programme main objective is -

  1. To improve patient compliance
  2. Achievements of high cure rates through DOTS
  3. To decrease development of resistance against antitubercular drugs
  4. To increase effectiveness

2. Achievements of high cure rates through DOTS

41

If after 2 months of conventional antitubercular therapy sputum smear examination is positive. It indicates -

  1. Treatment failure
  2. Return after default
  3. Resistant tuberculosis
  4. Category II failure

3. Resistant tuberculosis

42

A patient of tuberculosis was treated 5 years back. Now he presents with symptoms of cough, sputum culture was negative, X-ray changes show opacities. It did not respond to broad spectrum antibiotics. It belongs to which category?

  1. Category I
  2. Category II
  3. Category III
  4. Category IV

2. Category II

43

The pillars of RNTCP -

  1. Achievement of not less than 85% cure rate amongst infectious cases of tuberculosis through short course chemotherapy involving peripheral health functionary
  2. Detecting 70% of estimated cases through quality sputum microscopy
  3. Not involving NGOs in RNTCP
  4. Directly observed therapy (Short course) is a community based TB treatment and care strategy

4. Directly observed therapy (Short course) is a community based TB treatment and care strategy

44