Chemotherapy: bedaquiline: 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 · Chemotherapy: bedaquiline

Sample item

A 30-year-old woman with rifampicin-resistant tuberculosis is to start an oral regimen containing bedaquiline, with a fluoroquinolone and clofazimine. Which monitoring is essential and why?

AColour vision testing, because bedaquiline causes optic neuritisBSerum uric acid, because bedaquiline blocks urate secretionCSerial ECGs for the QTc interval, as these drugs prolong the QT intervalDAudiometry, because bedaquiline is ototoxic like aminoglycosides

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

The answer and the reasoning

C. Serial ECGs for the QTc interval, as these drugs prolong the QT interval

Bedaquiline inhibits mycobacterial ATP synthase and is used in drug-resistant tuberculosis. It prolongs the QT interval, and the effect adds to that of moxifloxacin and clofazimine, so baseline and follow-up ECGs with electrolyte correction are required. Hepatotoxicity is also monitored.

Option by option

A. Colour vision testing, because bedaquiline causes optic neuritis
Optic neuritis is characteristic of ethambutol and linezolid.
B. Serum uric acid, because bedaquiline blocks urate secretion
Hyperuricaemia is a pyrazinamide effect.
C. Serial ECGs for the QTc interval, as these drugs prolong the QT interval (correct)
Correct. Additive QT prolongation can lead to torsades.
D. Audiometry, because bedaquiline is ototoxic like aminoglycosides
Ototoxicity is the concern with injectable aminoglycosides and capreomycin.

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.

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is C, Serial ECGs for the QTc interval, as these drugs prolong the QT interval. Bedaquiline inhibits mycobacterial ATP synthase and is used in drug-resistant tuberculosis.

Why is "Colour vision testing, because bedaquiline causes optic neuritis" not the answer?

Optic neuritis is characteristic of ethambutol and linezolid.

Why is "Serum uric acid, because bedaquiline blocks urate secretion" not the answer?

Hyperuricaemia is a pyrazinamide effect.

Why is "Audiometry, because bedaquiline is ototoxic like aminoglycosides" not the answer?

Ototoxicity is the concern with injectable aminoglycosides and capreomycin.

What concept does this question test?

It tests Chemotherapy: bedaquiline in Pharmacology. It prolongs the QT interval, and the effect adds to that of moxifloxacin and clofazimine, so baseline and follow-up ECGs with electrolyte correction are required. Hepatotoxicity is also monitored.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Chemotherapy: bedaquiline?

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.