Tuberculosis: preventive therapy in a child contact: practice question

A PSM 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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PSM · Tuberculosis: preventive therapy in a child contact

Sample item

A 4-year-old boy with normal growth is a household contact of his father, who has newly diagnosed sputum-positive pulmonary tuberculosis. The child is asymptomatic and his chest radiograph is normal. What is the next best step under the national programme?

AObserve without drugs and review only if symptoms appearBExclude active disease clinically and give 6 months of isoniazid preventive therapyCRepeat BCG vaccinationDStart the four-drug intensive phase of anti-tuberculosis treatment

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

The answer and the reasoning

B. Exclude active disease clinically and give 6 months of isoniazid preventive therapy

Household contacts below 5 years of age of a pulmonary tuberculosis patient are at high risk of progression and are given tuberculosis preventive treatment once active disease is excluded. Isoniazid daily for 6 months is a standard regimen (shorter rifamycin-based regimens are also used). BCG does not prevent infection or substitute for preventive therapy in an exposed child.

Option by option

A. Observe without drugs and review only if symptoms appear
Watchful waiting leaves a high-risk young child exposed to progression to severe disease.
B. Exclude active disease clinically and give 6 months of isoniazid preventive therapy (correct)
Preventive isoniazid after excluding active disease is advised for young child contacts.
C. Repeat BCG vaccination
BCG revaccination has no role in preventing disease after household exposure.
D. Start the four-drug intensive phase of anti-tuberculosis treatment
Treatment for active disease is for symptomatic patients or radiological evidence, which is absent.

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 PSM question

What is the answer to this PSM question?

The best answer is B, Exclude active disease clinically and give 6 months of isoniazid preventive therapy. Household contacts below 5 years of age of a pulmonary tuberculosis patient are at high risk of progression and are given tuberculosis preventive treatment once active disease is excluded.

Why is "Observe without drugs and review only if symptoms appear" not the answer?

Watchful waiting leaves a high-risk young child exposed to progression to severe disease.

Why is "Repeat BCG vaccination" not the answer?

BCG revaccination has no role in preventing disease after household exposure.

Why is "Start the four-drug intensive phase of anti-tuberculosis treatment" not the answer?

Treatment for active disease is for symptomatic patients or radiological evidence, which is absent.

What concept does this question test?

It tests Tuberculosis: preventive therapy in a child contact in PSM. Isoniazid daily for 6 months is a standard regimen (shorter rifamycin-based regimens are also used). BCG does not prevent infection or substitute for preventive therapy in an exposed child.

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 Tuberculosis: preventive therapy in a child contact?

Practise biostatistics with small calculations until sensitivity, predictive values and risk measures are automatic. Then use the flashcards and the other PSM 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.