Infectious diseases: visceral leishmaniasis: 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 · Infectious diseases: visceral leishmaniasis

Sample item

A 25-year-old farmer from Bihar has had fever for 3 months, weight loss and abdominal swelling. He has massive splenomegaly and pancytopenia, and the rK39 rapid test is positive. Which treatment is the first-line choice under the Indian elimination programme?

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

The answer and the reasoning

D. Single-dose liposomal amphotericin B

Visceral leishmaniasis (kala-azar) is caused by Leishmania donovani and transmitted by sandflies, and is concentrated in Bihar, Jharkhand, West Bengal and Uttar Pradesh. Single-dose intravenous liposomal amphotericin B (10 mg/kg) is the first-line treatment under the national elimination programme, with high cure rates and easy delivery. Pentavalent antimonials are no longer effective in Bihar due to resistance.

Option by option

  • A. Chloroquine for 3 days

    Chloroquine treats malaria and has no effect against Leishmania.

  • B. Sodium stibogluconate for 30 days

    Antimonials have widespread resistance in the endemic region and are no longer used.

  • C. Metronidazole for 10 days

    Metronidazole treats amoebiasis and anaerobic infections, not leishmaniasis.

  • D. Single-dose liposomal amphotericin B (correct)

    A single infusion of liposomal amphotericin B is the programme's first-line regimen.

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.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Single-dose liposomal amphotericin B. Visceral leishmaniasis (kala-azar) is caused by Leishmania donovani and transmitted by sandflies, and is concentrated in Bihar, Jharkhand, West Bengal and Uttar Pradesh.

Why is "Chloroquine for 3 days" not the answer?

Chloroquine treats malaria and has no effect against Leishmania.

Why is "Sodium stibogluconate for 30 days" not the answer?

Antimonials have widespread resistance in the endemic region and are no longer used.

Why is "Metronidazole for 10 days" not the answer?

Metronidazole treats amoebiasis and anaerobic infections, not leishmaniasis.

What concept does this question test?

It tests Infectious diseases: visceral leishmaniasis in General Medicine. Single-dose intravenous liposomal amphotericin B (10 mg/kg) is the first-line treatment under the national elimination programme, with high cure rates and easy delivery. Pentavalent antimonials are no longer effective in Bihar due to resistance.

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 Infectious diseases: visceral leishmaniasis?

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.