Parasitology: visceral leishmaniasis treatment: practice question

A Microbiology 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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Microbiology · Parasitology: visceral leishmaniasis treatment

Sample item

A 28-year-old farmer from north Bihar has had fever for 3 months with massive splenomegaly and pancytopenia. The rK39 rapid test is positive. Which is the first-line treatment under the national kala-azar elimination programme?

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

The answer and the reasoning

A. Single-dose liposomal amphotericin B

In India a single intravenous dose of liposomal amphotericin B (10 mg/kg) is the first-line treatment for visceral leishmaniasis, with high cure rates and a short hospital stay. Antimonials were abandoned in Bihar because of widespread resistance. Miltefosine and paromomycin are used in combination regimens as alternatives.

Option by option

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

    A single dose of liposomal amphotericin B is the programme first-line regimen.

  • B. Sodium stibogluconate for 30 days

    Antimonials are no longer used in Bihar because of resistance.

  • C. Oral miltefosine alone for 28 days

    Miltefosine alone is not first line, is teratogenic and is mainly used in combination regimens.

  • D. Pentamidine for 15 days

    Pentamidine is no longer favoured because of toxicity such as diabetes mellitus and hypotension.

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 Microbiology question

What is the answer to this Microbiology question?

The best answer is A, Single-dose liposomal amphotericin B. In India a single intravenous dose of liposomal amphotericin B (10 mg/kg) is the first-line treatment for visceral leishmaniasis, with high cure rates and a short hospital stay.

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

Antimonials are no longer used in Bihar because of resistance.

Why is "Oral miltefosine alone for 28 days" not the answer?

Miltefosine alone is not first line, is teratogenic and is mainly used in combination regimens.

Why is "Pentamidine for 15 days" not the answer?

Pentamidine is no longer favoured because of toxicity such as diabetes mellitus and hypotension.

What concept does this question test?

It tests Parasitology: visceral leishmaniasis treatment in Microbiology. Antimonials were abandoned in Bihar because of widespread resistance. Miltefosine and paromomycin are used in combination regimens as alternatives.

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 Parasitology: visceral leishmaniasis treatment?

Make a one-line identity card for each organism: shape and stain, defining test, toxin, disease and drug. Then use the flashcards and the other Microbiology 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.