National programmes: TB preventive treatment: practice question

A PSM 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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PSM · National programmes: TB preventive treatment

Sample item

A 3-year-old asymptomatic child lives with his father, who has just been diagnosed with microbiologically confirmed pulmonary tuberculosis. Under the national TB programme, what is the correct approach for the child?

ARepeat BCG vaccinationBGive the full four-drug regimen without evaluationCObserve only, since he has no symptomsDExclude active TB by evaluation, then give TB preventive treatment such as 6 months of isoniazid

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

The answer and the reasoning

D. Exclude active TB by evaluation, then give TB preventive treatment such as 6 months of isoniazid

Young household contacts of a confirmed pulmonary TB case are at high risk of progression to severe disease. After clinical evaluation (and investigation as needed) excludes active TB, they are offered TB preventive treatment, for example isoniazid for 6 months. Starting full treatment without evaluation or doing nothing are both inappropriate.

Option by option

A. Repeat BCG vaccination
BCG revaccination is not recommended and gives no protection after exposure.
B. Give the full four-drug regimen without evaluation
A four-drug treatment regimen is for active disease and would be unjustified and risky without evaluation.
C. Observe only, since he has no symptoms
Asymptomatic young contacts are the group that benefits most from preventive therapy, so mere observation is inadequate.
D. Exclude active TB by evaluation, then give TB preventive treatment such as 6 months of isoniazid (correct)
Correct. Evaluate first, then give preventive therapy to the exposed child.

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.

Questions about this PSM question

What is the answer to this PSM question?

The best answer is D, Exclude active TB by evaluation, then give TB preventive treatment such as 6 months of isoniazid. Young household contacts of a confirmed pulmonary TB case are at high risk of progression to severe disease.

Why is "Repeat BCG vaccination" not the answer?

BCG revaccination is not recommended and gives no protection after exposure.

Why is "Give the full four-drug regimen without evaluation" not the answer?

A four-drug treatment regimen is for active disease and would be unjustified and risky without evaluation.

Why is "Observe only, since he has no symptoms" not the answer?

Asymptomatic young contacts are the group that benefits most from preventive therapy, so mere observation is inadequate.

What concept does this question test?

It tests National programmes: TB preventive treatment in PSM. After clinical evaluation (and investigation as needed) excludes active TB, they are offered TB preventive treatment, for example isoniazid for 6 months. Starting full treatment without evaluation or doing nothing are both inappropriate.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 National programmes: TB preventive treatment?

Practise biostatistics with small calculations until sensitivity, predictive values and risk measures are automatic. Then use the flashcards and the other PSM 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.