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Soal McQ TB dan Kanker Paru

Total questions: 52

Worksheet time: 26mins

Name
Class
Date
1.

A 45-year-old man, coughing up blood, shortness of breath, night sweats. BTA (+), GeneXpert: Rif-sensitive. Initial therapy?

a)

2HRZE / 4HR

b)

2RHZE / 6HE

c)

6HRZE

d)

2RHZ / 7HR

e)

2HRZE / 4HRE

2.

A 60-year-old woman, spinal TB, complains of pain and mild paralysis. Therapy?

a)

Standard OAT + corticosteroids

b)

OAT + surgery if there is neurological deficit

c)

Surgery only

d)

OAT only

e)

Just observation

3.

A 33-year-old man with HIV+, BTA (+), on OAT day 10, suddenly has severe shortness of breath and high fever. Diagnosis?

a)

TB reactivation

b)

IRIS

c)

Bacterial pneumonia

d)

TB RO

e)

Superinfection

4.

A 5-year-old child with TB, weight <10 kg, vomits after taking OAT. Best preparation choice?

a)

Half adult tablet

b)

FDC syrup OAT

c)

FDC child tablet

d)

Mix powder

e)

Single OAT

5.

A patient with TB RO, Hb 6 g/dL, platelets 80,000, leukocytes decreased. Which drug side effect is likely?

a)

Levofloxacin

b)

Clofazimine

c)

Linezolid

d)

Ethionamide

e)

Bedaquiline

6.

A 29-year-old man, coughing for 2 months, night sweats. IGRA and TST tests positive. Diagnosis?

a)

Latent TB

b)

Active TB

c)

TB RO

d)

Not TB

e)

Pneumonia

7.

A 40-year-old woman, lung cancer, EGFR (+), planned for targeted therapy. Choice of drug?

a)

Gefitinib

b)

Osimertinib

c)

Erlotinib

d)

Dacomitinib

e)

Alectinib

8.

A child with TB, weight 10 kg. The dose of INH is 10 mg/kg. How many mg of INH per day?

a)

50 mg

b)

100 mg

c)

200 mg

d)

150 mg

e)

75 mg

9.

A patient with TB RO experiences paresthesia and ataxia. Possible side effect from?

a)

Ethionamide

b)

Cycloserine

c)

Clofazimine

d)

Linezolid

e)

Levofloxacin

10.

A patient with TB RO with TCM results: MTB detected, Rif-resistant. DST: INH resistance. Initial therapy?

a)

OAT category 1

b)

9-month WHO regimen

c)

Individualized regimen

d)

6 Lfx-Cfz-Cs-Z-E / 12 Lfx-Cfz-Cs

e)

6 Bdq-Lfx-Lzd-Cfz-Cs / 12 Lfx-Lzd-Cfz-Cs

11.

A patient with TB RO on second-line regimen, complains of muscle pain, CK increased. Most likely causative drug?

a)

Levofloxacin

b)

Linezolid

c)

Ethionamide

d)

Clofazimine

e)

Bedaquiline

12.

A patient with TB RO, given bedaquiline, experiences prolonged QTc. What is the first step?

a)

Stop all medications

b)

Reduce all doses

c)

Stop bedaquiline

d)

Switch to standard regimen

e)

Give beta blocker

13.

A 50-year-old man, pulmonary TB, retreatment. Previous OAT history was irregular. What is the choice regimen?

a)

OAT category 1

b)

9-month regimen

c)

Individualized regimen

d)

Standard TB RO regimen

e)

OAT category 2

14.

A patient with TB RO who stopped treatment for 2 months wants to continue. What is the initial step?

a)

Re-evaluate

b)

Continue old regimen

c)

Switch to new regimen

d)

Repeat initial regimen

e)

Check culture

15.

A 12-year-old child with spinal TB, hospitalized. Is additional treatment needed?

a)

Steroids

b)

Rehabilitation

c)

Orthopedic surgery if needed

d)

Chemotherapy

e)

No additional treatment needed

16.

A patient with pulmonary TB, failed therapy, and culture shows extensive resistance. What is the correct term?

a)

MDR-TB

b)

XDR-TB

c)

Pre-XDR

d)

Mono-resistant

e)

Poliresistant

17.

A patient with TB, HIV+, CD4 <50. When is the best time to start ARV?

a)

Immediately

b)

2 weeks after OAT

c)

4 weeks after OAT

d)

After intensive phase

e)

After negative culture

18.

When is the best time to start ARV?

a)

Immediately

b)

2 weeks after OAT

c)

4 weeks after OAT

d)

After the intensive phase

e)

After negative culture

19.

A patient with TB HIV+ experiences fever and worsening lung infiltrates after starting ARV. What is the diagnosis?

a)

IRIS

b)

Relapse TB

c)

Resistance

d)

Secondary infection

e)

Aspiration pneumonia

20.

A 40-year-old man, HIV+, has shortness of breath, fever, negative sputum results, and desaturation while walking. What is the most common infection?

a)

Pneumocystis jirovecii

b)

TB

c)

Gram-negative bacteria

d)

Influenza

e)

RSV

21.

A 30-year-old woman has latent TB. What is the shortest and most effective therapy currently?

a)

6H

b)

3HR

c)

4R

d)

3HP

e)

9H

22.

A child with TB and pleural effusion has fluid with high LDH, high protein, and dominant lymphocytes. What is the diagnosis?

a)

Transudate

b)

TB Exudate

c)

Pneumonia

d)

Secondary infection effusion

e)

Empyema

23.

A 32-year-old woman with active TB is non-compliant with medication. Now she has drug-resistant TB and wants therapy at home. What must be done?

a)

Check culture

b)

Hospitalization

c)

DOTS therapy

d)

Psychology consultation

e)

Observation

24.

A 35-year-old man with culture-positive TB has resistance to rifampicin and isoniazid. What is the correct term?

a)

MDR-TB

b)

Pre-XDR

c)

Mono-resistant

d)

Polydrug-resistant

e)

XDR-TB

25.

An 8-year-old child is diagnosed with pulmonary TB. History of contact with an adult TB patient, cough for 3 weeks, weight loss, TST positive. What is the therapy?

a)

Half adult OAT

b)

Child FDC OAT

c)

Rifampicin only

d)

INH only

e)

Amoxicillin

26.

A patient with drug-resistant TB is undergoing therapy and experiences nausea, vomiting, and loss of appetite. What is the initial examination?

a)

AST and ALT

b)

Urea and creatinine

c)

Electrolytes

d)

Blood glucose

e)

Sputum examination

27.

In drug-resistant TB, with albumin <2.6, Hb <10, and thrombocytopenia, what needs to be monitored?

a)

Kidney function

b)

Complete blood count

c)

Culture examination

d)

Lung function

e)

TCM

28.

A HIV-positive man with low CD4 count has a lung infection. What is the specific examination for Pneumocystis jirovecii?

a)

Sputum culture

b)

TB test

c)

GMS bronchoalveolar examination

d)

CXR

e)

Serum IgG

29.

A 25-year-old woman with pulmonary TB vomits blood and has epigastric pain in the 3rd week of OAT. What drug might be causing this?

a)

Rifampicin

b)

Isoniazid

c)

Pyrazinamide

d)

Ethambutol

e)

Levofloxacin

30.

A patient with pulmonary TB has an albumin level of 2.0 g/dL. What should be given?

a)

High protein supplement

b)

Increase OAT

c)

Administer ARV

d)

Change regimen

e)

Add steroid

31.

A patient with drug-resistant TB has an inhA mutation. Which drug is likely to remain effective?

a)

INH

b)

Rifampicin

c)

Ethionamide

d)

Pyrazinamide

e)

PAS

32.

A 30-year-old man with drug-resistant TB is given levofloxacin. What side effect should be monitored?

a)

Hepatotoxicity

b)

Peripheral neuropathy

c)

Hearing impairment

d)

QT prolongation

e)

Myopathy

33.

A 40-year-old woman with pulmonary TB wants to give birth. Which OAT drug is safe during pregnancy?

a)

Streptomycin

b)

Ethionamide

c)

Pyrazinamide

d)

Kanamycin

e)

Amikacin

34.

A child with TB weighs 20 kg. The dose of rifampicin is 15 mg/kg. How many mg per day?

a)

150 mg

b)

200 mg

c)

250 mg

d)

300 mg

e)

100 mg

35.

A child with TB experiences joint pain and swelling at the start of OAT. Which drug is the cause?

a)

Isoniazid

b)

Rifampicin

c)

Ethambutol

d)

Pyrazinamide

e)

Streptomycin

36.

OAT mengalami nyeri sendi dan bengkak. Obat penyebab?

a)

Isoniazid

b)

Rifampisin

c)

Ethambutol

d)

Pyrazinamide

e)

Streptomisin

37.

Seorang pasien TB RO mendapat terapi lini kedua. Setelah 2 minggu, pasien mengeluh telinga berdenging. Obat mana penyebabnya?

a)

Levofloxacin

b)

Kanamisin

c)

Clofazimine

d)

Ethionamide

e)

Linezolid

38.

Pasien TB paru, selama terapi OAT menunjukkan peningkatan kadar bilirubin dan SGOT/SGPT. Obat yang paling hepatotoksik?

a)

Rifampisin

b)

Ethambutol

c)

Isoniazid

d)

Pyrazinamide

e)

Streptomisin

39.

Wanita TB RO, 2 bulan terapi, Hb turun drastis, anemia normokrom normositik. Obat tersangka?

a)

Linezolid

b)

Clofazimine

c)

Cycloserine

d)

Levofloxacin

e)

Ethionamide

40.

Seorang pria 35 tahun, TB RO, diberikan regimen bedaquiline. Lama pemberian bedaquiline menurut WHO?

a)

4 minggu

b)

8 minggu

c)

6 bulan

d)

12 bulan

e)

2 bulan

41.

Pasien TB dengan gangguan visual, terutama buta warna. Obat penyebab?

a)

Isoniazid

b)

Rifampisin

c)

Ethambutol

d)

Pyrazinamide

e)

Clofazimine

42.

TB paru, sudah 2 bulan OAT, tiba-tiba nyeri perut kanan atas. Pemeriksaan awal?

a)

Urinalisis

b)

Ureum kreatinin

c)

LFT (fungsi hati)

d)

CRP

e)

Pemeriksaan dahak ulang

43.

Pasien TB paru, tidak kunjung sembuh, ternyata tidak patuh minum obat. Istilah yang tepat?

a)

Failure

b)

Relaps

c)

Default

d)

Treatment complete

e)

Reinfection

44.

Anak 7 tahun TB, hasil GeneXpert: MTB detected, Rif-sensitive. Obat Rifampisin diberikan 15 mg/kg. Berat badan 18 kg. Dosis harian Rifampisin?

a)

270 mg

b)

200 mg

c)

225 mg

d)

250 mg

e)

180 mg

45.

Seorang pasien TB tulang dengan abses dingin dan kerusakan struktur vertebra. Tindakan?

a)

OAT saja

b)

Observasi

c)

Rehabilitasi

d)

OAT + debridement

e)

Radioterapi

46.

Pasien TB RO mendapat regimen 6 Bdq-Lfx-Lzd-Cfz-Cs. Setelah 3 bulan, batuk berkurang, dahak (-). Langkah selanjutnya?

a)

Stop semua obat

b)

Evaluasi efek samping

c)

Lanjut fase lanjutan

d)

Ganti regimen

e)

Ulang TCM

47.

Pasien TB dengan gangguan pendengaran. Obat tersangka?

a)

Rifampisin

b)

Ethambutol

c)

Streptomisin

d)

Pyrazinamide

e)

Clofazimine

48.

Seorang pasien TB RO dengan kadar natrium 120 mmol/L. Obat yang mungkin menyebabkan?

a)

Ethionamide

b)

Clofazimine

c)

Cycloserine

d)

Levofloxacin

e)

Linezolid

49.

Pasien TB RO terapi 6 bulan, muncul bintik kehitaman di kulit. Obat tersangka?

a)

Levofloxacin

b)

Clofazimine

c)

Linezolid

d)

Bedaquiline

e)

Ethionamide

50.

Pasien TB, minum INH dan Rifampisin, hasil SGPT 6x normal. Tindakan?

a)

Lanjutkan

b)

Stop semua OAT

c)

Ganti ke streptomisin

d)

Stop hanya Rifampisin

e)

Stop hanya INH

51.

Seorang wanita 35 tahun hamil, TB paru aktif. Terapi terbaik?

a)

OAT lengkap

b)

Hanya rifampisin

c)

INH dan streptomisin

d)

Rifampisin dan pyrazinamide

e)

Rifampisin dan etambutol

52.

Pasien TB RO, terapi 3 bulan, Hb tetap <8 g/dL. Obat kemungkinan?

a)

Clofazimine

b)

Levofloxacin

c)

Linezolid

d)

Pyrazinamide

e)

Kanamisin

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