Infectious diseases: NTEP drug-sensitive tuberculosis: practice question

A General Medicine 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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General Medicine · Infectious diseases: NTEP drug-sensitive tuberculosis

Sample item

A 40-year-old adult has newly diagnosed drug-sensitive pulmonary tuberculosis. Which regimen is prescribed under the National TB Elimination Programme?

ASix months of isoniazid and rifampicin onlyBTwo months of isoniazid, rifampicin, pyrazinamide and ethambutol, then four months of isoniazid, rifampicin and ethambutol, dailyCNine months of rifampicin aloneDTwo months of the four drugs followed by ten months of isoniazid alone

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

The answer and the reasoning

B. Two months of isoniazid, rifampicin, pyrazinamide and ethambutol, then four months of isoniazid, rifampicin and ethambutol, daily

Under NTEP, drug-sensitive TB is treated with a daily fixed-dose combination: a 2-month intensive phase of HRZE and a 4-month continuation phase of HRE, dosed by weight band. Adherence is supported by the Ni-kshay platform and DOT. Regimens differ for drug-resistant and CNS disease.

Option by option

A. Six months of isoniazid and rifampicin only
Two-drug therapy for six months omits pyrazinamide and ethambutol in the intensive phase.
B. Two months of isoniazid, rifampicin, pyrazinamide and ethambutol, then four months of isoniazid, rifampicin and ethambutol, daily (correct)
Correct. This is the standard 2HRZE plus 4HRE daily regimen.
C. Nine months of rifampicin alone
Rifampicin monotherapy would rapidly select resistant organisms.
D. Two months of the four drugs followed by ten months of isoniazid alone
Isoniazid alone in the continuation phase is inadequate and promotes resistance.

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 General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Two months of isoniazid, rifampicin, pyrazinamide and ethambutol, then four months of isoniazid, rifampicin and ethambutol, daily. Under NTEP, drug-sensitive TB is treated with a daily fixed-dose combination: a 2-month intensive phase of HRZE and a 4-month continuation phase of HRE, dosed by weight band.

Why is "Six months of isoniazid and rifampicin only" not the answer?

Two-drug therapy for six months omits pyrazinamide and ethambutol in the intensive phase.

Why is "Nine months of rifampicin alone" not the answer?

Rifampicin monotherapy would rapidly select resistant organisms.

Why is "Two months of the four drugs followed by ten months of isoniazid alone" not the answer?

Isoniazid alone in the continuation phase is inadequate and promotes resistance.

What concept does this question test?

It tests Infectious diseases: NTEP drug-sensitive tuberculosis in General Medicine. Adherence is supported by the Ni-kshay platform and DOT. Regimens differ for drug-resistant and CNS disease.

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 Infectious diseases: NTEP drug-sensitive tuberculosis?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.