Infectious diseases: brucellosis: 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.

Try it

General Medicine · Infectious diseases: brucellosis

Sample item

A 35-year-old dairy farmer in Punjab who drinks unpasteurised milk has had undulant fever with night sweats, low back pain with sacroiliitis, and hepatosplenomegaly for three weeks. Serum agglutination titre is high. What is the most appropriate treatment?

ADoxycycline alone for seven daysBRifampicin alone for six weeksCDoxycycline with rifampicin for six weeksDCeftriaxone for two weeks

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

The answer and the reasoning

C. Doxycycline with rifampicin for six weeks

Brucellosis from animal contact or unpasteurised dairy causes undulant fever, sweats, arthritis and sacroiliitis, with relapses if undertreated. Combination therapy with doxycycline and rifampicin for six weeks is the WHO-recommended regimen, and a short single-drug course relapses. Blood culture needs prolonged incubation.

Option by option

A. Doxycycline alone for seven days
A short single-drug course gives a high relapse rate.
B. Rifampicin alone for six weeks
Rifampicin monotherapy risks resistance and relapse and is not recommended.
C. Doxycycline with rifampicin for six weeks (correct)
A prolonged two-drug course reduces relapse in brucellosis.
D. Ceftriaxone for two weeks
Ceftriaxone is not a standard regimen and has poor intracellular activity.

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.

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Doxycycline with rifampicin for six weeks. Brucellosis from animal contact or unpasteurised dairy causes undulant fever, sweats, arthritis and sacroiliitis, with relapses if undertreated.

Why is "Doxycycline alone for seven days" not the answer?

A short single-drug course gives a high relapse rate.

Why is "Rifampicin alone for six weeks" not the answer?

Rifampicin monotherapy risks resistance and relapse and is not recommended.

Why is "Ceftriaxone for two weeks" not the answer?

Ceftriaxone is not a standard regimen and has poor intracellular activity.

What concept does this question test?

It tests Infectious diseases: brucellosis in General Medicine. Combination therapy with doxycycline and rifampicin for six weeks is the WHO-recommended regimen, and a short single-drug course relapses. Blood culture needs prolonged incubation.

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: brucellosis?

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.