Quiz 4: Management of childhood tuberculosis

Please choose the one, most correct answer to each question or statement.

1. Children with uncomplicated tuberculosis should be:
   • Admitted to hospital for the intensive phase of treatment
   • Admitted to hospital for bed rest during the first month of treatment
   • Admitted to hospital for the first week of treatment to assess whether they will have adverse effects to the drugs used
   • Treated at home and managed at the local clinic
2. How effective is multi-drug treatment of uncomplicated tuberculosis?
   • More than 90% of children can be cured.
   • Only 75% can be cured
   • Only 25% can be cured
   • Tuberculosis cannot be cured
3. How many drugs are usually used to treat drug sensitive tuberculosis HIV uninfected children?
   • One
   • Two
   • Three
   • Five
4. Which drug is included in the first-line treatment of tuberculosis in children?
   • INH
   • Bedaquiline
   • Streptomycin
   • Amikacin
5. Which drug is used in the continuation phase of drug-susceptible TB in younger children?
   • Rifampicin
   • Pyrazinamide
   • Ethionamide
   • Moxifloxacin
6. How long is the full course of treatment in uncomplicated tuberculosis in children?
   • Two months
   • Four months
   • Six months
   • Nine months
7. Which anti-TB drug may cause the urine to become orange?
   • INH
   • Rifampicin
   • Pyrazinamide
   • Ethambutol
8. How often are anti-tuberculous drugs taken?
   • Once a day, usually in the morning
   • Twice a day with meals
   • Three times a day
   • Three times with meals and the again when going to bed at night
9. Which drug is added to the treatment of tuberculous meningitis?
   • Penicillin
   • Ceftriaxone
   • Ethionamide
   • Sulphonamide
10. What is the great advantage of a fixed drug combination tablet?
    • It is much cheaper
    • It tastes better
    • Adherence is improved
    • The continuation phase of treatment can be reduced to two months
11. What is good adherence?
    • 100% of doses must be taken (no doses missed)
    • At least 80% of doses must be taken
    • At least 50% of doses must be taken
    • Medication must be taken at least once every day
12. Why is good adherence important in children?
    • It teaches the child to be disciplined
    • It reduces the risk of adverse effects
    • It reduces the risk of drug resistance
    • Children do not need to be monitored regularly
13. How can adherence be improved?
    • Seeing a doctor rather than a nurse at the clinic
    • Scolding the patient if adherence is poor
    • Threatening to stop treatment if adherence dose not improve
    • Help the patient understand the importance of good adherence
14. What is DOT?
    • A treatment method where a support person observes every dose being taken
    • A powerful new anti-TB drug
    • An anti-TB drug patch that is stuck on the skin every week
    • A scanning method to diagnose bone tuberculosis
15. What is a common cause of treatment failure in children?
    • The incorrect drugs are used for first-line treatment
    • The treatment is stopped too soon.
    • The intensive phase is too short
    • The patient develops severe hepatitis
16. Patients with multi-drug-resistant tuberculosis are resistant to:
    • At least INH and rifampicin
    • All anti-TB drugs
    • Kanamycin and capreomycin
    • BCG
17. If young children have both HIV and PTB:
    • The HIV infection should not be treated as it increases the risk of adverse effects.
    • The HIV should only be treated when the full course of anti-TB treatment is completed.
    • Only start the anti-TB treatment when the child has received six months of antiretroviral treatment.
    • First treat the PTB then start antiretroviral therapy within 8 weeks of starting anti-TB treatment.
18. What antiretroviral drug change may be needed if rifampicin is given to HIV-positive children on anti-TB treatment?
    • The dose of lopinavir/ritonavir should be halved
    • Lopinavir/ritonavir should be boosted with additional ritonavir
    • Daily vitamin C supplements
    • VThe dose of efavirenz should be doubled
19. What is IRIS?
    • A typical X-ray pattern seen with pulmonary tuberculosis
    • A new test for extensive drug resistance
    • An unexpected clinical deterioration in patients who have been responding well to treatment
    • A non-governmental organisation which provides food parcels for children with tuberculosis
20. A very useful method of monitoring a child’s response to treatment is:
    • Regularly plot the child’s weight in the Road-to-Health booklet
    • Measure the CD4 count
    • Measure drug levels in the blood
    • Repeating the chest X-ray