Antifungals: mucormycosis: 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 · Antifungals: mucormycosis

Sample item

A 52-year-old man with uncontrolled diabetes presents with diabetic ketoacidosis, facial swelling and a black necrotic eschar on the palate. Biopsy shows broad, ribbon-like aseptate hyphae branching at right angles. Which antifungal should be started along with surgical debridement?

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

The answer and the reasoning

A. Liposomal amphotericin B

The picture is rhino-orbito-cerebral mucormycosis. Liposomal amphotericin B is first-line, and rapid control of diabetes and acidosis and extensive debridement are essential. Voriconazole, echinocandins and fluconazole have no reliable activity against the Mucorales.

Option by option

  • A. Liposomal amphotericin B (correct)

    Correct. Amphotericin B has reliable activity against Mucorales.

  • B. Fluconazole

    Fluconazole has no activity against moulds and is used for candidiasis and cryptococcosis.

  • C. Voriconazole

    Voriconazole is the drug of choice for invasive aspergillosis but is inactive against Mucorales.

  • D. Caspofungin

    Caspofungin has poor activity against Mucorales and Cryptococcus.

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 Pharmacology questions

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is A, Liposomal amphotericin B. The picture is rhino-orbito-cerebral mucormycosis.

Why is "Fluconazole" not the answer?

Fluconazole has no activity against moulds and is used for candidiasis and cryptococcosis.

Why is "Voriconazole" not the answer?

Voriconazole is the drug of choice for invasive aspergillosis but is inactive against Mucorales.

Why is "Caspofungin" not the answer?

Caspofungin has poor activity against Mucorales and Cryptococcus.

What concept does this question test?

It tests Antifungals: mucormycosis in Pharmacology. Liposomal amphotericin B is first-line, and rapid control of diabetes and acidosis and extensive debridement are essential. Voriconazole, echinocandins and fluconazole have no reliable activity against the Mucorales.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Antifungals: mucormycosis?

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.