skip to main content

Chronic beryllium disease — SCE Respiratory MCQ

Instant feedback + full explanation. One question, done properly.

HardOccupational lung diseaseChronic beryllium diseaseSCE Respiratory

A patient taking rifampicin, isoniazid, pyrazinamide and ethambutol develops anorexia and right-upper-quadrant discomfort. ALT is 4.2 times the upper limit of normal and bilirubin is rising. What is the immediate drug action?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Stop the three hepatotoxic drugs during liver assessment

Symptoms of hepatitis with ALT above three times the upper limit of normal meet a standard threshold for interrupting hepatotoxic antituberculosis drugs. Rifampicin, isoniazid and pyrazinamide are stopped while alternative causes are assessed; a safe bridging and sequential reintroduction plan requires TB-specialist input.

Reference: NICE NG33 recommendations for tuberculosis (Updated 15 February 2024): https://www.nice.org.uk/guidance/ng33/chapter/Recommendations; Clinical standards for management of antituberculosis drug-induced liver injury (Published 2018): https://pmc.ncbi.nlm.nih.gov/articles/PMC6308384/