Infectious diseases: TB preventive treatment: 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: TB preventive treatment

Sample item

A 30-year-old asymptomatic person with HIV infection has no cough, fever, weight loss or night sweats and a normal chest X-ray. What is the recommended management under the National TB Elimination Programme?

ARifampicin alone for two yearsBTB preventive treatment, such as 6 months of isoniazid or a 3HP regimen, after excluding active TBCFull four-drug antituberculosis therapyDNo treatment until symptoms develop

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

The answer and the reasoning

B. TB preventive treatment, such as 6 months of isoniazid or a 3HP regimen, after excluding active TB

People living with HIV are at high risk of progression to active tuberculosis, so after symptom screening excludes active disease, TB preventive treatment is offered. Options include 6 months of isoniazid and the weekly isoniazid plus rifapentine regimen for 3 months. Four-drug therapy is reserved for active disease.

Option by option

A. Rifampicin alone for two years
Prolonged rifampicin monotherapy is not a recommended regimen.
B. TB preventive treatment, such as 6 months of isoniazid or a 3HP regimen, after excluding active TB (correct)
Correct. Preventive therapy after excluding active TB reduces progression.
C. Full four-drug antituberculosis therapy
Four-drug therapy treats active disease and is not appropriate here.
D. No treatment until symptoms develop
Waiting for symptoms misses the chance to prevent disease.

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, TB preventive treatment, such as 6 months of isoniazid or a 3HP regimen, after excluding active TB. People living with HIV are at high risk of progression to active tuberculosis, so after symptom screening excludes active disease, TB preventive treatment is offered.

Why is "Rifampicin alone for two years" not the answer?

Prolonged rifampicin monotherapy is not a recommended regimen.

Why is "Full four-drug antituberculosis therapy" not the answer?

Four-drug therapy treats active disease and is not appropriate here.

Why is "No treatment until symptoms develop" not the answer?

Waiting for symptoms misses the chance to prevent disease.

What concept does this question test?

It tests Infectious diseases: TB preventive treatment in General Medicine. Options include 6 months of isoniazid and the weekly isoniazid plus rifapentine regimen for 3 months. Four-drug therapy is reserved for active disease.

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 Infectious diseases: TB preventive treatment?

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.