Communicable diseases: kala-azar treatment: practice question

A PSM 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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PSM · Communicable diseases: kala-azar treatment

Sample item

A 28-year-old man from a kala-azar endemic block in Bihar has fever for 2 months, massive splenomegaly and pancytopenia, and an rK39 strip test is positive. Which is the first-line treatment under the national 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 (Leishmania donovani, transmitted by the sandfly Phlebotomus argentipes) is treated in India with a single infusion of liposomal amphotericin B 10 mg/kg as first line. Resistance to antimonials in Bihar has made them obsolete, and miltefosine, which is teratogenic, and paromomycin are alternatives. Early case detection and indoor residual spraying support elimination.

Option by option

  • A. Oral miltefosine for 28 days

    Miltefosine is a second-line or combination option and is contraindicated in pregnancy.

  • B. Sodium stibogluconate for 30 days

    Antimonials are no longer used in Bihar because of widespread resistance.

  • C. Pentamidine daily

    Pentamidine is not a recommended first-line drug for kala-azar in India.

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

    Correct. Single-dose liposomal amphotericin B is the first-line regimen in India.

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 PSM question

What is the answer to this PSM question?

The best answer is D, Single-dose liposomal amphotericin B. Visceral leishmaniasis (Leishmania donovani, transmitted by the sandfly Phlebotomus argentipes) is treated in India with a single infusion of liposomal amphotericin B 10 mg/kg as first line.

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

Miltefosine is a second-line or combination option and is contraindicated in pregnancy.

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

Antimonials are no longer used in Bihar because of widespread resistance.

Why is "Pentamidine daily" not the answer?

Pentamidine is not a recommended first-line drug for kala-azar in India.

What concept does this question test?

It tests Communicable diseases: kala-azar treatment in PSM. Resistance to antimonials in Bihar has made them obsolete, and miltefosine, which is teratogenic, and paromomycin are alternatives. Early case detection and indoor residual spraying support elimination.

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 Communicable diseases: kala-azar treatment?

Practise biostatistics with small calculations until sensitivity, predictive values and risk measures are automatic. Then use the flashcards and the other PSM 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.