A patient is considered as having multidrug-resistant TB if he has resistance to:

Appeared in: UPUMS Nsg officer-2023

Explanation

Multidrug-resistant tuberculosis (MDR-TB) is specifically defined by resistance to the two most powerful first-line anti-TB drugs: isoniazid (H) and rifampicin (R).
These two drugs are the most effective agents in standard TB treatment regimens, and resistance to both significantly complicates therapy.
The World Health Organization (WHO) and national guidelines use this precise definition to classify cases and guide treatment protocols.
Treatment for MDR-TB requires the use of second-line drugs, which are often more toxic, less effective, and need to be taken for a much longer duration (up to 2 years or more).

Option A: Resistance to rifampicin and streptomycin, without resistance to isoniazid, is classified as poly-drug resistant TB, not MDR-TB.
Option B: Resistance to isoniazid and pyrazinamide, without resistance to rifampicin, is classified as poly-drug resistant TB.
Option D: Resistance to isoniazid and streptomycin, without resistance to rifampicin, is also classified as poly-drug resistant TB.

Clinical Relevance

Nursing practice connection: Use the key finding related to Definition of Multidrug-Resistant Tuberculosis (MDR-TB) to guide bedside assessment, documentation, and the next nursing action.
Identifying MDR-TB is critical for initiating appropriate treatment with second-line drugs and preventing further transmission of resistant strains in the community.
Nurses play a key role in patient education regarding the importance of adherence to complex and lengthy MDR-TB treatment regimens to prevent treatment failure and the development of further resistance (XDR-TB).
MDR-TB is a significant public health problem, requiring robust infection control measures in healthcare settings and contact tracing to limit its spread.

How to Approach the Question

First, identify the key term in the question, which is 'multidrug-resistant TB' (MDR-TB).
This is a factual recall question that requires knowledge of a specific medical definition.
Recall the standard definition of MDR-TB as defined by major health organizations like the WHO.
The definition specifically requires resistance to the two most potent first-line drugs.
Evaluate each option to see which one matches this definition: resistance to both isoniazid and rifampicin.
Eliminate the other options, recognizing them as examples of poly-drug resistance.

Concept Tested & Keywords

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Practise the full UPUMS Nsg officer-2023

Attempt every question from this paper in a timed mock, then review the full solution for each one.