RUHS, Jaipur, M.Sc Nursing Entrance Exam-2015
Medical Surgical Nursing
Easy
Which of the following is treatment duration for category IV (DOTS Plus) MDR-TB?
Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2015
Explanation
- The term 'Category IV' or 'DOTS-Plus' refers to the older, conventional treatment strategy for Multidrug-Resistant Tuberculosis (MDR-TB).
- This standard long-course regimen has a total duration of at least 24 months.
- It is structured into two phases: an initial Intensive Phase (IP) of 6-9 months, which includes injectable drugs, and a subsequent Continuation Phase (CP) of 18 months with only oral drugs.
- The combination of the IP (minimum 6 months) and CP (18 months) results in a total treatment time of 24 months.
Why Other Options Were Wrong
- Option A: A 6-month regimen is used for drug-sensitive TB (Category I) and also for the newer, all-oral BPaLM regimen for specific types of drug-resistant TB, not the conventional Category IV MDR-TB.
- Option B: A 9-month duration is associated with the newer, shorter all-oral regimen for eligible MDR-TB patients, which lasts 9-11 months. It is not the duration for the conventional Category IV regimen.
- Option C: 18 months represents the duration of the Continuation Phase (CP) only in the conventional 24-month regimen. It is not the total treatment duration.
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Treatment duration for Multidrug-Resistant Tuberculosis (MDR-TB) under Category IV (DOTS-Plus) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- Managing a 24-month treatment regimen requires exceptional nursing care focused on patient adherence, which is the biggest challenge and predictor of success.
- Nurses must diligently monitor for severe adverse drug reactions associated with second-line TB drugs, such as ototoxicity and nephrotoxicity (from injectables like Kanamycin) and psychosis or depression (from Cycloserine).
- Patient education is critical. The nurse must explain the long duration, the importance of completing the full course to prevent further resistance, and management strategies for side effects.
How to Approach the Question
- First, identify the key terms in the question: 'Category IV', 'DOTS Plus', and 'MDR-TB'.
- Recognize that 'Category IV' refers to the older, conventional classification for treating MDR-TB.
- Recall the standard duration for this long-course therapy.
- Differentiate the total treatment duration from the duration of its individual phases (Intensive and Continuation).
- Evaluate the given options. 6 and 9 months are durations for drug-sensitive TB or newer, shorter DR-TB regimens. 18 months is the duration of the continuation phase, not the total treatment.
- Select the option that corresponds to the total duration of the conventional regimen, which is 24 months.
Concept Tested & Keywords
- Concept Tested: Treatment duration for Multidrug-Resistant Tuberculosis (MDR-TB) under Category IV (DOTS-Plus).
- Stem keywords: treatment duration, category IV, DOTS Plus, MDR-TB
- Lead-in keywords: Which
Question ID
QkgdJfzI9e6msCfHrgNjB2
Reference Book
E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart B (pp 202-403 of 604) p. 36-38
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