License and Loksewa class 015424901, 9808222095

Biochemical test of Mycobacterium sp

Biochemical Test Mycobacterium spp
 Niacin test  M. tb: Strong Positve
 M. cheloni and M simiae : also Positve
 Arysulfatase test  Atypical mycobacterium ( MOTT) positive
 Catalase test  Atypical Mycobacterium: Strong positive
 M. tb and M. bovies: weak Positve
 Peroxidase test  M.tb and M. bovies: Strong Positive
 Atypical mycobacterium: negative
 Neutral red Test  Positive for
 M. tb, M. bovies, M avium and M. ulcerans
 Amidase test  Postitive for atypical mycobacterium
 Nitrate reduction test  M. tb +ve and M. bovies: -ve
Note;
 Biochemcial test used to dddiffferentiate M. tb from M bovies : Nitrate test
 Which biochemical test used to differentiate Atypical mycobacterium from other
: Arysulphatase test and Amidase test

Note
Virulence factor of M. tb
 Cording factor: Glycolipid derivative of Mycolic acid.
Inhibition of migration of Polymorphonuclear cell (
Neutrophil)
 Cell Surface Glycolipid: Inhibit phagosome formation
 Animicrobial ressitance due to mutation

Media for M. tb
Egg based Medium Agar based Medium Liquid Medium
- Lowenstein Jensen Middle brock 7H10 Dubo's Medium
Medddium Middle Brock 7H11 Middle Brock 7H9 broth
- Petragnani Bacteck 12B Medium
- Wallenstein
- LJ with pyruvic acid

- M. tb has generation time 12-24 hour, colonies usually appear in 2-3

weeks and may some time requires 8 weeks

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 License and Loksewa class 015424901, 9808222095

MCQS of Mycobacterium
tuberculosis
1. Which of the following is the primary causative agent of tuberculosis (TB)?
A) Mycobacterium leprae B) Mycobacterium tuberculosis
C) Mycobacterium avium D) Mycobacterium bovis
Answer: B) Mycobacterium tuberculosis
2. What is the most common method used to diagnose tuberculosis?
A) Blood culture B) Chest X-ray
C) Sputum smear microscopy D) Urine test
Answer: C) Sputum smear microscopy ( Acid Fast Stainig)
3. What is the primary treatment regimen for drug-sensitive tuberculosis?
A) Single-drug therapy
B) Combination of Isoniazid, Rifampin, Ethambutol, and Pyrazinamide
C) Combination of Rifampin and Streptomycin
D) Combination of Isoniazid and Rifampin only
Answer: B) Combination of Isoniazid, Rifampin, Ethambutol, and Pyrazinamide
4. Which test is used to identify latent tuberculosis infection (LTBI)?
A) Tuberculin skin test (TST) B) Chest X-ray
C) Sputum culture D) Blood culture
Answer: A) Tuberculin skin test (TST)
5. What is the primary method of transmission for Mycobacterium
tuberculosis?
A) Contact with contaminated surfaces B) Airborne droplets
C) Fecal-oral route D) Vector-borne transmission
Answer: B) Airborne droplets
6. Which drug is known for its potential side effect of hepatotoxicity in
tuberculosis treatment?
A) Rifampin B) Isoniazid
C) Ethambutol D) Pyrazinamide
Answer: B) Isoniazid
7. Which of the following is a common symptom of active tuberculosis?
A) Fever and night sweats B) Abdominal pain
C) Joint pain D) Headache
Answer: A) Fever and night sweats
8. What type of bacteria is Mycobacterium tuberculosis classified as?
A) Gram-positive cocci B) Gram-negative rods
C) Acid-fast bacilli D) Non-acid-fast bacilli
Answer: C) Acid-fast bacilli
9. What does the "BCG" vaccine protect against?
A) Hepatitis B B) Tuberculosis
C) Influenza D) Measles
Answer: B) Tuberculosis
10. Which of the following conditions is NOT a risk factor for developing
tuberculosis?

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A) Immunosuppression B) Diabetes mellitus

C) Good nutritional status D) HIV infection
Answer: C) Good nutritional status
11. What is the primary target organ of Mycobacterium tuberculosis in
pulmonary tuberculosis?
A) Liver B) Kidneys
C) Lungs D) Intestines
Answer: C) Lungs
12. In a person with multidrug-resistant tuberculosis (MDR-TB), which drugs
are typically ineffective?
A) Isoniazid and Rifampin B) Ethambutol and Pyrazinamide
C) Rifampin and Streptomycin D) Isoniazid and Pyrazinamide
Answer: A) Isoniazid and Rifampin
13. What is the primary purpose of the QuantiFERON-TB Gold test?
A) To diagnose active tuberculosis B) To detect latent tuberculosis infection
C) To evaluate drug resistance D) To assess liver function
Answer: B) To detect latent tuberculosis infection
14. Which laboratory test can confirm the presence of Mycobacterium
tuberculosis in a patient's sputum?
A) Gram stain
B) Acid-fast bacilli (AFB) smear
C) Enzyme-linked immunosorbent assay (ELISA)
D) Polymerase chain reaction (PCR)
Answer: B) Acid-fast bacilli (AFB) smear
15. What is the primary challenge in treating drug-resistant tuberculosis?
A) Lack of available medications
B) High cost and long duration of treatment
C) High risk of transmission
D) Short incubation period
Answer: B) High cost and long duration of treatment
16. What is the role of the "directly observed therapy" (DOT) strategy in
tuberculosis treatment?
A) To reduce the risk of drug-resistant strains by ensuring adherence to therapy
B) To monitor liver function during treatment
C) To identify latent tuberculosis infections
D) To improve imaging techniques for TB diagnosis
Answer: A) To reduce the risk of drug-resistant strains by ensuring adherence to therapy
17. Which of the following is a common side effect of Rifampin used in
tuberculosis treatment?
A) Hyperglycemia B) Hepatitis
C) Hypotension D) Skin rash
Answer: B) Hepatitis
18. What is the significance of the "Ziehl-Neelsen stain" in the diagnosis of
tuberculosis?
A) It stains bacteria to identify acid-fast bacilli
B) It highlights cell wall structures
C) It distinguishes between Gram-positive and Gram-negative bacteria
D) It detects enzyme activity in Mycobacterium tuberculosis

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Answer: A) It stains bacteria to identify acid-fast bacilli

19. What is the purpose of the “Chest X-ray” in the evaluation of
tuberculosis?
A) To identify liver abnormalities
B) To detect pulmonary damage and lesions associated with active tuberculosis
C) To assess kidney function
D) To measure blood glucose levels
Answer: B) To detect pulmonary damage and lesions associated with active tuberculosis
20. Which of the following conditions can be a result of untreated or
inadequately treated tuberculosis?
A) Meningitis B) Rheumatoid arthritis
C) Diabetes mellitus D) Asthma
Answer: A) Meningitis
21. What is the role of Pyrazinamide in tuberculosis therapy?
A) To prevent drug resistance
B) To kill Mycobacterium tuberculosis in acidic environments like those found in
macrophages
C) To treat concurrent infections
D) To provide symptomatic relief
Answer: B) To kill Mycobacterium tuberculosis in acidic environments like those found in
macrophages
22. What does a positive Tuberculin Skin Test (TST) indicate?
A) Active tuberculosis infection B) Recent exposure to tuberculosis
C) Current treatment for tuberculosis D) Complete cure from tuberculosis
Answer: B) Recent exposure to tuberculosis
23. In which situation is the use of molecular tests, such as PCR, most
beneficial for tuberculosis diagnosis?
A) To detect latent tuberculosis infection
B) To identify drug-resistant strains of Mycobacterium tuberculosis
C) To evaluate liver function
D) To assess patient compliance with treatment
Answer: B) To identify drug-resistant strains of Mycobacterium tuberculosis
24. What is the primary reason for the emergence of multidrug-resistant
tuberculosis (MDR-TB)?
A) Inadequate nutritional support during treatment
B) Insufficient use of vaccines
C) Incomplete or improper use of anti-tuberculosis medications
D) Excessive use of antibiotics for other infections
Answer: C) Incomplete or improper use of anti-tuberculosis medications
25. Which of the following groups is at higher risk for developing active
tuberculosis after a latent infection?
A) Individuals with a high BMI
B) Immunocompromised individuals, such as those with HIV
C) Individuals who regularly exercise
D) Individuals with a history of asthma
Answer: B) Immunocompromised individuals, such as those with HIV
26. What type of hypersensitivity reaction is involved in the Tuberculin Skin
Test (TST)?

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A) Type I hypersensitivity B) Type II hypersensitivity

C) Type III hypersensitivity D) Type IV hypersensitivity
Answer: D) Type IV hypersensitivity
27. Which of the following is a potential complication of pulmonary
tuberculosis?
A) Fibrosis and lung scarring B) Acute renal failure
C) Hyperthyroidism D) Chronic migraine
Answer: A) Fibrosis and lung scarring
28. Which demographic group is most likely to benefit from the BCG vaccine?
A) Adults with active tuberculosis
B) Infants and young children in high-risk areas
C) Elderly individuals
D) Individuals with HIV
Answer: B) Infants and young children in high-risk areas
29. What is the primary method used for determining drug susceptibility of
Mycobacterium tuberculosis?
A) Clinical history
B) Sputum smear microscopy
C) Culture-based drug susceptibility testing
D) Chest X-ray
Answer: C) Culture-based drug susceptibility testing
30. What is the role of Ethambutol in tuberculosis treatment?
A) To inhibit the synthesis of mycobacterial cell walls
B) To kill the bacteria directly
C) To prevent drug resistance
D) To enhance the absorption of other anti-tuberculosis drugs
Answer: A) To inhibit the synthesis of mycobacterial cell walls
31. What is the key feature of Mycobacterium tuberculosis that helps it resist
decolorization during acid-fast staining?
A) Its thick peptidoglycan layer B) Its lipid-rich cell wall
C) Its capsule D) Its endospores
Answer: B) Its lipid-rich cell wall
32. What is the role of the “GeneXpert” test in tuberculosis diagnosis?
A) It provides a rapid molecular diagnosis of tuberculosis and detects drug resistance.
B) It evaluates the extent of lung damage.
C) It measures the immune response to tuberculosis.
D) It identifies latent tuberculosis infection.
Answer: A) It provides a rapid molecular diagnosis of tuberculosis and detects drug
resistance.
33. Which of the following is NOT typically a side effect of the anti-
tuberculosis drug Rifampin?
A) Orange-red discoloration of bodily fluids B) Hepatotoxicity
C) Visual disturbances D) Gastrointestinal upset
Answer: C) Visual disturbances
34. In the context of tuberculosis, what does the term "extrapulmonary" refer
to?
A) Tuberculosis infection confined to the lungs

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B) Tuberculosis infection involving organs outside the lungs, such as the lymph nodes
or kidneys
C) Tuberculosis infection restricted to the skin
D) Tuberculosis infection in the gastrointestinal tract
Answer: B) Tuberculosis infection involving organs outside the lungs, such as the lymph
nodes or kidneys
35. Which test is most useful for monitoring the effectiveness of tuberculosis
treatment?
A) Tuberculin Skin Test (TST) B) Chest X-ray
C) Sputum smear microscopy D) Blood glucose test
Answer: C) Sputum smear microscopy
36. What is the significance of the “Mantoux test” in tuberculosis screening?
A) It is used to diagnose drug-resistant tuberculosis.
B) It is used to identify individuals who have been exposed to Mycobacterium
tuberculosis.
C) It assesses lung function.
D) It detects active tuberculosis infection.
Answer: B) It is used to identify individuals who have been exposed to Mycobacterium
tuberculosis.
37. Which of the following is a common symptom of extrapulmonary
tuberculosis?
A) Persistent cough B) Lymphadenopathy
C) Hemoptysis D) Chest pain
Answer: B) Lymphadenopathy
38. Which of the following factors can contribute to the development of
multidrug-resistant tuberculosis (MDR-TB)?
A) Proper adherence to the prescribed treatment regimen
B) Incomplete or irregular treatment regimens
C) Early diagnosis and intervention
D) Use of a single drug for the entire treatment course
Answer: B) Incomplete or irregular treatment regimens
39. What is the primary aim of directly observed therapy (DOT) in
tuberculosis management?
A) To improve patient comfort during treatment
B) To ensure medication adherence and prevent drug resistance
C) To reduce the cost of treatment
D) To expedite diagnostic testing
Answer: B) To ensure medication adherence and prevent drug resistance
40. What type of hypersensitivity reaction is primarily involved in the
pathogenesis of tuberculosis?
A) Type I hypersensitivity B) Type II hypersensitivity
C) Type III hypersensitivity D) Type IV hypersensitivity
Answer: D) Type IV hypersensitivity
41. What is the most important environmental factor that increases the risk of
tuberculosis transmission?
A) Poor ventilation B) High humidity
C) Low temperatures D) High altitudes
Answer: A) Poor ventilation

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42. Which diagnostic method is useful in confirming a diagnosis of drug-

resistant tuberculosis when culture results are not available?
A) Sputum smear microscopy B) Chest X-ray
C) GeneXpert MTB/RIF assay D) Tuberculin Skin Test (TST)
Answer: C) GeneXpert MTB/RIF assay
43. Which condition is commonly associated with an increased risk of
developing tuberculosis?
A) Hyperthyroidism
B) Chronic obstructive pulmonary disease (COPD)
C) Obesity
D) Hyperlipidemia
Answer: B) Chronic obstructive pulmonary disease (COPD)
44. What is the typical duration of the standard initial phase of treatment for
drug-sensitive tuberculosis?
A) 2 weeks B) 4 weeks
C) 6 months D) 1 year
Answer: C) 6 months
45. In the context of tuberculosis, what does “cavitatory lesions” refer to?
A) Lesions in the gastrointestinal tract
B) Areas of necrosis within the lung parenchyma that have formed cavities
C) Lesions in the lymph nodes
D) Skin lesions associated with disseminated TB
Answer: B) Areas of necrosis within the lung parenchyma that have formed cavities
46. Which of the following diagnostic tests is most specific for detecting
Mycobacterium tuberculosis in clinical specimens?
A) Acid-fast bacilli (AFB) smear
B) Tuberculin Skin Test (TST)
C) Culture on Löwenstein-Jensen medium
D) Chest X-ray
Answer: C) Culture on Löwenstein-Jensen medium

47. What is the recommended duration for the continuation phase of

treatment for drug-sensitive tuberculosis after the initial phase?
A) 2 months B) 4 months
C) 6 months D) 12 months
Answer: B) 4 months
48. Which population is typically targeted for the BCG (Bacillus Calmette-
Guérin) vaccination?
A) Adults over 50 years old
B) Children in high tuberculosis incidence areas
C) Pregnant women
D) Immunocompromised individuals
Answr: B) Children in high tuberculosis incidence areas
49. What does the presence of "caseating granulomas" in a biopsy specimen
suggest?
A) Fungal infection B) Non-caseating granuloma
C) Tuberculosis infection D) Viral infection

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Answer: C) Tuberculosis infection

50. Which factor is least likely to contribute to the development of active
tuberculosis disease in an individual with a latent tuberculosis infection?
A) Recent travel to a high-risk country
B) High-level immunosuppression
C) High socioeconomic status
D) Recent exposure to a person with active tuberculosis
Answer: C) High socioeconomic status
51. What is the primary benefit of using the QuantiFERON-TB Gold test over
the Tuberculin Skin Test (TST)?
A) QuantiFERON-TB Gold is less affected by prior BCG vaccination.
B) QuantiFERON-TB Gold provides results more quickly.
C) QuantiFERON-TB Gold does not require a follow-up visit.
D) QuantiFERON-TB Gold is less expensive.
Answer: A) QuantiFERON-TB Gold is less affected by prior BCG vaccination.
52. Which type of tuberculosis is characterized by the involvement of the
central nervous system?
A) Pulmonary tuberculosis B) Extrapulmonary tuberculosis
C) Lymphatic tuberculosis D) Cutaneous tuberculosis
Answer: B) Extrapulmonary tuberculosis
53. What is the primary goal of directly observed therapy (DOT) for
tuberculosis patients?
A) To monitor liver function
B) To ensure adherence to the full course of treatment and prevent relapse
C) To manage side effects of medications
D) To provide nutritional support
Answer: B) To ensure adherence to the full course of treatment and prevent relapse

54. Which anti-tuberculosis drug is associated with optic neuritis as a side

effect?
A) Rifampin B) Isoniazid
C) Ethambutol D) Pyrazinamide
Answer: C) Ethambutol
55. What does a "false-negative" result in the Tuberculin Skin Test (TST)
indicate?
A) Absence of tuberculosis infection B) Recent tuberculosis exposure
C) Poor immune response or anergy D) Presence of latent tuberculosis
infection
Answer: C) Poor immune response or anergy
56. What is the most common site for extrapulmonary tuberculosis?
A) Bones and joints B) Skin
C) Gastrointestinal tract D) Eyes
Answer: A) Bones and joints
57. What is the main advantage of the GeneXpert MTB/RIF test over
traditional smear microscopy for tuberculosis diagnosis?
A) It provides faster results and detects drug resistance
B) It is less expensive

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C) It does not require laboratory equipment

D) It can be used to diagnose all types of infections
Answer: A) It provides faster results and detects drug resistance
58. In the context of tuberculosis treatment, what does the term "DOTS"
stand for?
A) Directly Observed Treatment Short-course
B) Directly Observed Therapy Standard
C) Drug-Resistant Therapy Strategy
D) Diagnostic Observation of Tuberculosis Syndrome
Answer: A) Directly Observed Treatment Short-course
59. What is the primary purpose of the “Chest X-ray” in monitoring
tuberculosis treatment?
A) To assess the presence of drug resistance
B) To monitor the resolution of pulmonary lesions
C) To determine the presence of side effects from medications
D) To evaluate liver function
Answer: B) To monitor the resolution of pulmonary lesions
60. What is the most likely reason for a patient with tuberculosis to have a
"high AFB smear" but negative culture results?
A) The patient has a very early stage of tuberculosis.
B) The patient has multidrug-resistant tuberculosis.
C) The specimen was contaminated.
D) The specimen was improperly collected or handled.
Answer: D) The specimen was improperly collected or handled.
61. What is the primary purpose of the “Löwenstein-Jensen medium” in
tuberculosis diagnostics?
A) To enhance the growth of Mycobacterium tuberculosis
B) To neutralize acidic environments
C) To test for drug resistance
D) To identify non-tuberculous mycobacteria
Answer: A) To enhance the growth of Mycobacterium tuberculosis
62. Which of the following is NOT a common symptom of active pulmonary
tuberculosis?
A) Chronic cough B) Weight loss
C) Persistent diarrhea D) Night sweats
Answer: C) Persistent diarrhea
63. Which of the following patient populations is typically excluded from
receiving the BCG vaccine?
A) Infants in high-incidence areas B) Immunocompromised individuals
C) Health care workers D) Pregnant women
Answer: B) Immunocompromised individuals
64. What is the primary reason for combining multiple anti-tuberculosis
drugs in treatment regimens?
A) To reduce the risk of drug interactions
B) To improve patient compliance
C) To prevent the development of drug-resistant strains
D) To reduce the duration of treatment
Answer: C) To prevent the development of drug-resistant strains

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65. What does the “GxAlert” feature of the GeneXpert system do?
A) It alerts the laboratory if the test results indicate drug resistance.
B) It provides automatic quality control for each test.
C) It sends notifications about new tuberculosis cases to public health authorities.
D) It alerts healthcare providers to the need for further diagnostic testing.
Answer: A) It alerts the laboratory if the test results indicate drug resistance.
66. Which of the following is a common complication of untreated or
inadequately treated tuberculosis?
A) Pulmonary fibrosis B) Hypoglycemia
C) Osteoporosis D) Hyperthyroidism
Answer: A) Pulmonary fibrosis
67. What is the standard method for detecting drug-resistant strains of
Mycobacterium tuberculosis?
A) Sputum smear microscopy B) Chest X-ray
C) Culture-based drug susceptibility testing D) Tuberculin Skin Test (TST)
Answer: C) Culture-based drug susceptibility testing
68. What is the primary role of Isoniazid in the treatment of tuberculosis?
A) To kill the bacteria by inhibiting cell wall synthesis
B) To increase patient appetite
C) To reduce the cough reflex
D) To alleviate symptoms of tuberculosis
Answer: A) To kill the bacteria by inhibiting cell wall synthesis

69. Which of the following drugs is typically NOT included in the initial
regimen for treating drug-sensitive tuberculosis?
A) Rifampin B) Isoniazid
C) Ethambutol D) Vancomycin
Answer: D) Vancomycin
70. In the context of tuberculosis, what does "latent tuberculosis infection
(LTBI)" mean?
A) Active disease with symptoms
B) Infection that is contained and not symptomatic
C) Resistant strain of tuberculosis
D) Fully cured tuberculosis infection
Answer: B) Infection that is contained and not symptomatic
71. Which method is commonly used to monitor the effectiveness of
tuberculosis treatment over time?
A) Skin biopsy B) Repeat sputum smear microscopy
C) Blood glucose testing D) Bone marrow biopsy
Answer: B) Repeat sputum smear microscopy
72. What is a major limitation of using the Tuberculin Skin Test (TST) in
populations with prior BCG vaccination?
A) It may yield false-negative results
B) It may yield false-positive results
C) It is not sensitive enough for early diagnosis
D) It cannot differentiate between drug-resistant and drug-sensitive TB
Answer: B) It may yield false-positive results

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73. What type of drug resistance is characterized by resistance to Isoniazid

and Rifampin but susceptibility to other first-line anti-tuberculosis drugs?
A) Multidrug-resistant tuberculosis (MDR-TB)
B) Extensively drug-resistant tuberculosis (XDR-TB)
C) Rifampin-resistant tuberculosis (RR-TB)
D) Drug-susceptible tuberculosis
Answer: A) Multidrug-resistant tuberculosis (MDR-TB)
74. What is the role of Pyrazinamide in tuberculosis treatment?
A) To prevent the formation of drug-resistant strains
B) To enhance the effectiveness of other anti-tuberculosis drugs
C) To kill bacteria in acidic environments, such as within macrophages
D) To reduce symptoms of tuberculosis
Answer: C) To kill bacteria in acidic environments, such as within macrophages
75. Which of the following is NOT a recommended strategy for preventing
tuberculosis transmission?
A) Use of masks by individuals with active TB
B) Improving ventilation in living spaces
C) Regular use of prophylactic antibiotics for high-risk contacts
D) Delaying diagnosis until symptoms are severe
Answer: D) Delaying diagnosis until symptoms are severe
76. Which of the following is NOT a characteristic of Mycobacterium
tuberculosis?
A) It is an aerobic bacterium. B) It has a thick lipid-rich cell wall.
C) It is Gram-negative. D) It is classified as an acid-fast bacillus.
Answer: C) It is Gram-negative.
77. Wat is the main reason for using Rifampin and Isoniazid together in
tuberculosis treatment?
A) To prevent liver toxicity
B) To reduce the duration of therapy
C) To enhance the bactericidal activity and prevent resistance
D) To treat co-infections
Answer: C) To enhance the bactericidal activity and prevent resistance
78. In tuberculosis treatment, what does the acronym "DOT" stand for?
A) Directly Observed Therapy B) Directly Observed Treatment
C) Drug-Resistant Observed Therapy D) Drug-Resistant Observed Treatment
Answer: B) Directly Observed Treatment
79. What is the role of the “Tuberculin Skin Test (TST)” in tuberculosis
management?
A) To confirm active tuberculosis infection
B) To screen for latent tuberculosis infection
C) To measure the response to anti-tuberculosis drugs
D) To identify drug-resistant strains
Answer: B) To screen for latent tuberculosis infection
80. Which of the following is a common side effect of Ethambutol?
A) Hepatitis B) Optic neuritis
C) Gastrointestinal bleeding D) Skin rash
Answer: B) Optic neuritis

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81. What does a positive GeneXpert MTB/RIF test indicate?

A) Presence of Mycobacterium tuberculosis and resistance to Rifampin
B) Presence of non-tuberculous mycobacteria
C) Absence of tuberculosis
D) Presence of latent tuberculosis infection
Answer: A) Presence of Mycobacterium tuberculosis and resistance to Rifampin
82. What is the significance of "cavitary lesions" seen on a chest X-ray in the
context of tuberculosis?
A) They indicate an early stage of the disease.
B) They suggest the presence of a fungal infection.
C) They are associated with active tuberculosis and potential for transmission.
D) They are related to non-tuberculous mycobacterial infections.
Answer: C) They are associated with active tuberculosis and potential for transmission.

83. Which of the following is a common method for detecting latent

tuberculosis infection?
A) Sputum culture
B) Chest X-ray
C) Tuberculin Skin Test (TST) or Interferon-gamma release assays (IGRAs)
D) Sputum smear microscopy
Answer: C) Tuberculin Skin Test (TST) or Interferon-gamma release assays (IGRAs)
84. What is the primary mode of transmission for Mycobacterium
tuberculosis?
A) Direct contact with contaminated surfaces
B) Airborne droplets from coughs or sneezes
C) Contaminated food and water
D) Insect bites
Answer: B) Airborne droplets from coughs or sneezes
85. What is the recommended treatment duration for latent tuberculosis
infection with Isoniazid?
A) 2 months B) 4 months
C) 6 months D) 9 months
Answer: D) 9 months
86. What is the primary method for diagnosing multidrug-resistant
tuberculosis (MDR-TB)?
A) Chest X-ray
B) Sputum smear microscopy
C) Culture-based drug susceptibility testing
D) Tuberculin Skin Test (TST)
Answer: C) Culture-based drug susceptibility testing
87. What is the role of the “BCG vaccine” in tuberculosis prevention?
A) It provides immunity against all types of tuberculosis.
B) It primarily prevents severe forms of tuberculosis in children.
C) It cures active tuberculosis.
D) It eliminates drug-resistant strains of tuberculosis.
Answer: B) It primarily prevents severe forms of tuberculosis in children.
88. What does a "false-positive" result in a Tuberculin Skin Test (TST)
suggest?

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A) The individual has active tuberculosis.

B) The individual has been exposed to Mycobacterium tuberculosis or has had a prior
BCG vaccination.
C) The individual has never been exposed to tuberculosis.
D) The individual has a different type of bacterial infection.
Answer: B) The individual has been exposed to Mycobacterium tuberculosis or has had a
prior BCG vaccination.
89. Which of the following drugs is used to treat extensively drug-resistant
tuberculosis (XDR-TB)?
A) Rifampin B) Streptomycin
C) Linezolid D) Pyrazinamide
Answer: C) Linezolid

90. In which population is the risk of tuberculosis reactivation the highest?

A) Healthy young adults
B) Individuals with chronic diseases such as diabetes or HIV
C) Older adults with no other health issues
D) Children with no history of TB exposure
Answer: B) Individuals with chronic diseases such as diabetes or HIV
91. Which of the following statements about the BCG vaccine is true?
A) The BCG vaccine is 100% effective in preventing all forms of tuberculosis.
B) The BCG vaccine is primarily effective in preventing pulmonary tuberculosis in
adults.
C) The BCG vaccine is more effective in preventing severe forms of tuberculosis in
children.
D) The BCG vaccine is only effective in individuals who have never been exposed to
tuberculosis.
Answer: C) The BCG vaccine is more effective in preventing severe forms of tuberculosis in
children.
92. What is the recommended initial treatment regimen for drug-sensitive
tuberculosis?
A) Rifampin, Isoniazid, Pyrazinamide, and Ethambutol
B) Rifampin and Isoniazid only
C) Rifampin and Ethambutol only
D) Isoniazid and Pyrazinamide only
Answer: A) Rifampin, Isoniazid, Pyrazinamide, and Ethambutol
93. In which scenario is a “GeneXpert” test most beneficial?
A) When assessing the severity of tuberculosis disease
B) When diagnosing latent tuberculosis infection
C) When detecting Mycobacterium tuberculosis and identifying Rifampin resistance
D) When monitoring liver function during treatment
Answer: C) When detecting Mycobacterium tuberculosis and identifying Rifampin
resistance
94. What does the term "Extensively Drug-Resistant Tuberculosis (XDR-TB)"
refer to?
A) Tuberculosis resistant to Isoniazid and Rifampin only
B) Tuberculosis resistant to Rifampin, Isoniazid, and at least one of the second-line
drugs
C) Tuberculosis that is resistant to all first-line drugs

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D) Tuberculosis that is resistant to all second-line drugs

Answer: B) Tuberculosis resistant to Rifampin, Isoniazid, and at least one of the second-line
drugs
95. Which of the following tests is commonly used to confirm the presence of
active tuberculosis in a patient with respiratory symptoms?
A) Interferon-gamma release assays (IGRAs)
B) Tuberculin Skin Test (TST)
C) Sputum smear microscopy and culture
D) Chest X-ray only
Answer: C) Sputum smear microscopy and culture
96. What is the primary mechanism by which Mycobacterium tuberculosis
resists the effects of anti-tuberculosis drugs?
A) Alteration of drug targets
B) Production of beta-lactamase enzymes
C) Increased drug absorption
D) Decreased cell wall permeability
Answer: A) Alteration of drug targets
97. How is the “Mantoux test” read and interpreted?
A) By measuring the diameter of induration after 48-72 hours
B) By assessing the color change of the skin immediately after injection
C) By the size of the injection site swelling at the time of administration
D) By the level of pain reported by the patient
Answer: A) By measuring the diameter of induration after 48-72 hours
98. What is the significance of “caseous necrosis” found in granulomas on a
biopsy of a suspected tuberculosis infection?
A) It indicates a fungal infection.
B) It suggests the presence of tuberculosis.
C) It is a sign of viral infection.
D) It represents a bacterial infection other than tuberculosis.
Answer: B) It suggests the presence of tuberculosis.
99. Which of the following is NOT a typical first-line anti-tuberculosis drug?
A) Rifampin B) Isoniazid
C) Ethambutol D) Amikacin
Answer: D) Amikacin
100. Which of the following groups is recommended to receive routine
screening for latent tuberculosis infection?
A) All healthy adults
B) Individuals with recent exposure to tuberculosis, healthcare workers, and those
with weakened immune systems
C) Children with no symptoms
D) Pregnant women without any risk factors
Answer: B) Individuals with recent exposure to tuberculosis, healthcare workers, and those
with weakened immune systems
101. In patients undergoing tuberculosis treatment, which of the following is a
common indicator of treatment failure?
A) Negative sputum smear after 2 months
B) Persistent cough and fever despite treatment
C) Decreased white blood cell count

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D) Improved chest X-ray findings

Answer: B) Persistent cough and fever despite treatment
102. What is the primary role of Pyrazinamide in the tuberculosis treatment
regimen?
A) To act as a first-line agent for latent TB
B) To kill Mycobacterium tuberculosis in acidic environments, such as within
macrophages
C) To improve patient adherence to treatment
D) To reduce inflammation
Answer: B) To kill Mycobacterium tuberculosis in acidic environments, such as within
macrophages
103. Which of the following methods is best for detecting Mycobacterium
tuberculosis DNA directly in clinical specimens?
A) Acid-fast bacilli smear
B) Chest X-ray
C) PCR (Polymerase Chain Reaction)
D) Tuberculin Skin Test (TST)
Answer: C) PCR (Polymerase Chain Reaction)
104. What is the significance of "pleural effusion" in a patient with suspected
tuberculosis?
A) It indicates a respiratory infection not related to tuberculosis.
B) It is a sign of disseminated tuberculosis or extrapulmonary involvement.
C) It suggests a need for surgical intervention.
D) It indicates a benign condition unrelated to tuberculosis.
Answer: B) It is a sign of disseminated tuberculosis or extrapulmonary involvement.

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