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Test 4: Management of childhood tuberculosis

Please choose the one most correct answer to each question or statement.

  1. Children with uncomplicated tuberculosis should be:
    • Admitted to hospital for the intensive phase of treatment
    • Admitted to hospital for bed rest during the first month of treatment
    • Admitted to hospital for the first week of treatment to assess whether they will have adverse effects to the drugs used
    • Treated at home and managed at the local clinic
  2. How effective is multi-drug treatment of uncomplicated tuberculosis?
    • More than 90% of children can be cured.
    • Only 75% can be cured
    • Only 25% can be cured
    • Tuberculosis cannot be cured
  3. How many drugs are usually used to treat drug sensitive tuberculosis HIV uninfected children?
    • One
    • Two
    • Three
    • Five
  4. Which drug is included in the first-line treatment of tuberculosis in children?
    • INH
    • Ethambutol
    • Streptomycin
    • Amikacin
  5. Which drug is used in the continuation phase of drug-susceptible TB in younger children?
    • Rifampicin
    • Pyrazinamide
    • Ethionamide
    • Moxifloxacin
  6. How long is the full course of treatment in uncomplicated tuberculosis in children?
    • Two months
    • Four months
    • Six months
    • Nine months
  7. Which anti-TB drug may cause the urine to become orange?
    • INH
    • Rifampicin
    • Pyrazinamide
    • Ethambutol
  8. How often are anti-tuberculous drugs taken?
    • Once a day, usually in the morning
    • Twice a day with meals
    • Three times a day
    • Three times with meals and the again when going to bed at night
  9. Which drug is added to the treatment of tuberculous meningitis?
    • Penicillin
    • Ceftriaxone
    • Ethionamide
    • Sulphonamide
  10. What is the great advantage of a fixed drug combination tablet?
    • It is much cheaper
    • It tastes better
    • Adherence is improved
    • The continuation phase of treatment can be reduced to two months
  11. What is good adherence?
    • 100% of doses must be taken (no doses missed)
    • At least 80% of doses must be taken
    • At least 50% of doses must be taken
    • Medication must be taken at least once every day
  12. Why is good adherence important in children?
    • It teaches the child to be disciplined
    • It reduces the risk of adverse effects
    • It reduces the risk of drug resistance
    • Children do not need to be monitored regularly
  13. How can adherence be improved?
    • Seeing a doctor rather than a nurse at the clinic
    • Scolding the patient if adherence is poor
    • Threatening to stop treatment if adherence dose not improve
    • Help the patient understand the importance of good adherence
  14. What is DOT?
    • A treatment method where a support person observes every dose being taken
    • A powerful new anti-TB drug
    • An anti-TB drug patch that is stuck on the skin every week
    • A scanning method to diagnose bone tuberculosis
  15. What is a common cause of treatment failure in children?
    • The incorrect drugs are used for first-line treatment
    • The treatment is stopped too soon.
    • The intensive phase is too short
    • The patient develops severe hepatitis
  16. Patients with multi-drug-resistant tuberculosis are resistant to:
    • INH and rifampicin
    • All anti-TB drugs
    • Kanamycin and capreomycin
    • BCG
  17. If young children have both HIV and PTB:
    • The HIV infection should not be treated as it increases the risk of adverse effects.
    • The HIV should only be treated when the full course of anti-TB treatment is completed.
    • Only start the anti-TB treatment when the child has received six months of antiretroviral treatment.
    • First treat the PTB then start antiretroviral therapy within 8 weeks of starting anti-TB treatment.
  18. What antiretroviral drug change may be needed if rifampicin is given to HIV-positive children on anti-TB treatment?
    • The dose of lopinavir/ritonavir should be halved
    • Lopinavir/ritonavir should be boosted with additional ritonavir
    • Daily vitamin C supplements
    • VThe dose of efavirenz should be doubled
  19. What is IRIS?
    • A typical X-ray pattern seen with pulmonary tuberculosis
    • A new test for extensive drug resistance
    • An unexpected clinical deterioration in patients who have been responding well to treatment
    • A non-governmental organisation which provides food parcels for children with tuberculosis
  20. A very useful method of monitoring a child’s response to treatment is:
    • Regularly plot the child’s weight in the Road-to-Health booklet
    • Measure the CD4 count
    • Measure drug levels in the blood
    • Repeating the chest X-ray