Chemotherapy: pyrazinamide and uric acid: practice question

A Pharmacology 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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Pharmacology · Chemotherapy: pyrazinamide and uric acid

Sample item

During the intensive phase of antitubercular therapy, a 45-year-old man has a swollen, intensely painful first metatarsophalangeal joint, and serum uric acid is 11 mg/dL. Which drug is most likely responsible?

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

The answer and the reasoning

C. Pyrazinamide

Pyrazinoic acid, the active metabolite of pyrazinamide, inhibits tubular secretion of urate and causes hyperuricaemia. Gout or arthralgia may follow, and treatment is with NSAIDs or colchicine while the antitubercular drug is generally continued. Pyrazinamide is also hepatotoxic.

Option by option

  • A. Streptomycin

    Streptomycin causes vestibular and renal toxicity.

  • B. Rifampicin

    Rifampicin causes orange secretions, hepatitis and enzyme induction.

  • C. Pyrazinamide (correct)

    Correct. Reduced renal urate secretion raises serum uric acid.

  • D. Isoniazid

    Isoniazid causes hepatitis and neuropathy rather than hyperuricaemia.

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 Pharmacology question

What is the answer to this Pharmacology question?

The best answer is C, Pyrazinamide. Pyrazinoic acid, the active metabolite of pyrazinamide, inhibits tubular secretion of urate and causes hyperuricaemia.

Why is "Streptomycin" not the answer?

Streptomycin causes vestibular and renal toxicity.

Why is "Rifampicin" not the answer?

Rifampicin causes orange secretions, hepatitis and enzyme induction.

Why is "Isoniazid" not the answer?

Isoniazid causes hepatitis and neuropathy rather than hyperuricaemia.

What concept does this question test?

It tests Chemotherapy: pyrazinamide and uric acid in Pharmacology. Gout or arthralgia may follow, and treatment is with NSAIDs or colchicine while the antitubercular drug is generally continued. Pyrazinamide is also hepatotoxic.

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 Chemotherapy: pyrazinamide and uric acid?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology 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.