Antitubercular drugs: pyrazinamide: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Antitubercular drugs: pyrazinamide

Sample item

Three weeks after starting four-drug therapy for pulmonary tuberculosis, a man develops an acutely painful, red, swollen first metatarsophalangeal joint. Which drug is the most likely cause?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Pyrazinamide

Pyrazinamide is converted to pyrazinoic acid, which competes for tubular secretion of uric acid, leading to hyperuricaemia and sometimes acute gout. Arthralgia is common with it. Treatment is with NSAIDs, and the antitubercular regimen is usually continued.

Option by option

  • A. Pyrazinamide (correct)

    Correct. Reduced renal urate secretion by pyrazinoic acid precipitates gout.

  • B. Isoniazid

    Isoniazid causes neuropathy and hepatitis, and drug-induced lupus rarely.

  • C. Rifampicin

    Rifampicin typically causes orange body fluids, hepatitis and flu-like syndrome, not gout.

  • D. Streptomycin

    Streptomycin causes vestibular and renal toxicity, not hyperuricaemia.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is A, Pyrazinamide. Pyrazinamide is converted to pyrazinoic acid, which competes for tubular secretion of uric acid, leading to hyperuricaemia and sometimes acute gout.

Why is "Isoniazid" not the answer?

Isoniazid causes neuropathy and hepatitis, and drug-induced lupus rarely.

Why is "Rifampicin" not the answer?

Rifampicin typically causes orange body fluids, hepatitis and flu-like syndrome, not gout.

Why is "Streptomycin" not the answer?

Streptomycin causes vestibular and renal toxicity, not hyperuricaemia.

What concept does this question test?

It tests Antitubercular drugs: pyrazinamide in Pharmacology. Arthralgia is common with it. Treatment is with NSAIDs, and the antitubercular regimen is usually continued.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Antitubercular drugs: pyrazinamide?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.