Antimalarials: severe malaria: practice question

A Pharmacology 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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Pharmacology · Antimalarials: severe malaria

Sample item

A 30-year-old man with Plasmodium falciparum malaria is comatose with parasitaemia of 12%, jaundice and creatinine of 3 mg/dL. Which is the preferred antimalarial?

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

The answer and the reasoning

B. Intravenous artesunate

He has severe falciparum malaria with cerebral and renal involvement. Parenteral artesunate clears parasites faster and lowers mortality compared with quinine, and is preferred. Follow-on oral ACT is given once he can swallow.

Option by option

  • A. Oral primaquine alone

    Primaquine is a gametocidal drug and does not treat severe disease.

  • B. Intravenous artesunate (correct)

    Correct. Intravenous artesunate is the first-line parenteral drug for severe malaria.

  • C. Oral artemether-lumefantrine

    An oral combination is for uncomplicated malaria, and a comatose patient cannot take oral drugs reliably.

  • D. Oral chloroquine

    Chloroquine resistance in P. falciparum makes it unreliable.

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 Pharmacology question

What is the answer to this Pharmacology question?

The best answer is B, Intravenous artesunate. He has severe falciparum malaria with cerebral and renal involvement.

Why is "Oral primaquine alone" not the answer?

Primaquine is a gametocidal drug and does not treat severe disease.

Why is "Oral artemether-lumefantrine" not the answer?

An oral combination is for uncomplicated malaria, and a comatose patient cannot take oral drugs reliably.

Why is "Oral chloroquine" not the answer?

Chloroquine resistance in P. falciparum makes it unreliable.

What concept does this question test?

It tests Antimalarials: severe malaria in Pharmacology. Parenteral artesunate clears parasites faster and lowers mortality compared with quinine, and is preferred. Follow-on oral ACT is given once he can swallow.

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 Antimalarials: severe malaria?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology 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.