Oral medicine and oral cancer: rhino-orbital mucormycosis: practice question

A Dentistry 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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Dentistry · Oral medicine and oral cancer: rhino-orbital mucormycosis

Sample item

A diabetic patient in ketoacidosis has fever, facial pain and a black necrotic ulcer on the hard palate. KOH preparation shows broad, ribbon-like, non-septate hyphae branching at right angles. What is the best management?

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

The answer and the reasoning

C. Intravenous amphotericin B with extensive surgical debridement and glycaemic control

This is mucormycosis, an angioinvasive fungal infection favoured by ketoacidosis and immunosuppression. Treatment combines early liposomal or conventional amphotericin B, wide debridement of necrotic tissue and correction of the underlying metabolic problem. Delay is associated with high mortality.

Option by option

  • A. Topical nystatin and observation

    Topical nystatin cannot treat an invasive angioinvasive fungus.

  • B. Intravenous acyclovir

    Acyclovir treats herpesvirus infection and not fungal disease.

  • C. Intravenous amphotericin B with extensive surgical debridement and glycaemic control (correct)

    Correct. Antifungal polyene plus surgery plus control of diabetes is the standard of care.

  • D. Oral fluconazole alone

    Fluconazole is not active against Mucorales.

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 Dentistry question

What is the answer to this Dentistry question?

The best answer is C, Intravenous amphotericin B with extensive surgical debridement and glycaemic control. This is mucormycosis, an angioinvasive fungal infection favoured by ketoacidosis and immunosuppression.

Why is "Topical nystatin and observation" not the answer?

Topical nystatin cannot treat an invasive angioinvasive fungus.

Why is "Intravenous acyclovir" not the answer?

Acyclovir treats herpesvirus infection and not fungal disease.

Why is "Oral fluconazole alone" not the answer?

Fluconazole is not active against Mucorales.

What concept does this question test?

It tests Oral medicine and oral cancer: rhino-orbital mucormycosis in Dentistry. Treatment combines early liposomal or conventional amphotericin B, wide debridement of necrotic tissue and correction of the underlying metabolic problem. Delay is associated with high mortality.

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 Oral medicine and oral cancer: rhino-orbital mucormycosis?

Learn the dental formula, eruption ages and tooth structure once, as tables. Then use the flashcards and the other Dentistry 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.