Tropical infections: practice question

A General Medicine 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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General Medicine · Tropical infections

Sample item

A farmer who waded through flood water develops fever, severe calf muscle pain, conjunctival suffusion, jaundice and acute kidney injury with only mildly raised transaminases. Which is the most appropriate antimicrobial?

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

The answer and the reasoning

B. Intravenous benzylpenicillin or ceftriaxone

This is severe leptospirosis (Weil disease) caused by spirochaetes shed in rat urine. Features are myalgia, conjunctival suffusion, hepatorenal involvement and bleeding. Penicillin or ceftriaxone is given for severe disease, and doxycycline for mild disease and prophylaxis.

Option by option

  • A. Oral albendazole

    Albendazole treats helminthic infection and has no role here.

  • B. Intravenous benzylpenicillin or ceftriaxone (correct)

    Correct. Beta-lactams are effective for severe leptospirosis.

  • C. Intravenous liposomal amphotericin B

    Amphotericin B treats systemic fungal infection and is not indicated.

  • D. Oral chloroquine

    Chloroquine treats susceptible malaria, which does not typically cause conjunctival suffusion with calf tenderness after flooding.

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.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Intravenous benzylpenicillin or ceftriaxone. This is severe leptospirosis (Weil disease) caused by spirochaetes shed in rat urine.

Why is "Oral albendazole" not the answer?

Albendazole treats helminthic infection and has no role here.

Why is "Intravenous liposomal amphotericin B" not the answer?

Amphotericin B treats systemic fungal infection and is not indicated.

Why is "Oral chloroquine" not the answer?

Chloroquine treats susceptible malaria, which does not typically cause conjunctival suffusion with calf tenderness after flooding.

What concept does this question test?

It tests Tropical infections in General Medicine. Features are myalgia, conjunctival suffusion, hepatorenal involvement and bleeding. Penicillin or ceftriaxone is given for severe disease, and doxycycline for mild disease and prophylaxis.

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 Tropical infections?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.