Respiratory medicine: rifampicin-resistant TB: 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 · Respiratory medicine: rifampicin-resistant TB

Sample item

A patient with newly diagnosed rifampicin-resistant pulmonary TB, no fluoroquinolone resistance and no contraindications is eligible for a six-month all-oral regimen. Which regimen is recommended?

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

The answer and the reasoning

A. BPaLM: bedaquiline, pretomanid, linezolid and moxifloxacin

WHO and the Indian programme endorse the six-month BPaLM regimen for eligible patients with rifampicin-resistant TB who are fluoroquinolone susceptible. Linezolid toxicity and QT effects require monitoring. Injectable-containing long regimens are being phased out.

Option by option

  • A. BPaLM: bedaquiline, pretomanid, linezolid and moxifloxacin (correct)

    Correct. BPaLM is the preferred six-month regimen.

  • B. HRZE for another 6 months

    Repeating first-line drugs is ineffective against rifampicin resistance.

  • C. Streptomycin plus isoniazid

    Streptomycin and isoniazid cannot treat MDR-TB.

  • D. Eighteen months with injectable kanamycin

    Injectable agents are no longer preferred.

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.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is A, BPaLM: bedaquiline, pretomanid, linezolid and moxifloxacin. WHO and the Indian programme endorse the six-month BPaLM regimen for eligible patients with rifampicin-resistant TB who are fluoroquinolone susceptible.

Why is "HRZE for another 6 months" not the answer?

Repeating first-line drugs is ineffective against rifampicin resistance.

Why is "Streptomycin plus isoniazid" not the answer?

Streptomycin and isoniazid cannot treat MDR-TB.

Why is "Eighteen months with injectable kanamycin" not the answer?

Injectable agents are no longer preferred.

What concept does this question test?

It tests Respiratory medicine: rifampicin-resistant TB in General Medicine. Linezolid toxicity and QT effects require monitoring. Injectable-containing long regimens are being phased out.

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 Respiratory medicine: rifampicin-resistant TB?

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.