Infectious diseases: cryptosporidiosis in HIV: practice question

A General Medicine 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.

Try it

General Medicine · Infectious diseases: cryptosporidiosis in HIV

Sample item

A man with HIV and a CD4 count of 40 cells per microlitre has had profuse watery diarrhoea for three weeks. A modified acid-fast stain of stool shows round oocysts of 4 to 6 micrometres. Which measure is most important in management?

AOral metronidazole for ten days or moreBAntiretroviral therapy with fluid replacementCOral albendazole for a full monthDOral ciprofloxacin for a full week

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

The answer and the reasoning

B. Antiretroviral therapy with fluid replacement

Cryptosporidium causes chronic watery diarrhoea in advanced HIV. No drug is reliably effective, so immune reconstitution with antiretroviral therapy plus fluids and electrolytes is the cornerstone. Nitazoxanide has limited activity.

Option by option

A. Oral metronidazole for ten days or more
Metronidazole treats giardiasis and amoebiasis and has no activity against Cryptosporidium.
B. Antiretroviral therapy with fluid replacement (correct)
Correct. Immune recovery clears the infection, and fluid replacement is supportive.
C. Oral albendazole for a full month
Albendazole is useful for microsporidia and helminths, not for Cryptosporidium.
D. Oral ciprofloxacin for a full week
Ciprofloxacin treats bacterial enteritis and does not clear the parasite.

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.

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Antiretroviral therapy with fluid replacement. Cryptosporidium causes chronic watery diarrhoea in advanced HIV.

Why is "Oral metronidazole for ten days or more" not the answer?

Metronidazole treats giardiasis and amoebiasis and has no activity against Cryptosporidium.

Why is "Oral albendazole for a full month" not the answer?

Albendazole is useful for microsporidia and helminths, not for Cryptosporidium.

Why is "Oral ciprofloxacin for a full week" not the answer?

Ciprofloxacin treats bacterial enteritis and does not clear the parasite.

What concept does this question test?

It tests Infectious diseases: cryptosporidiosis in HIV in General Medicine. No drug is reliably effective, so immune reconstitution with antiretroviral therapy plus fluids and electrolytes is the cornerstone. Nitazoxanide has limited activity.

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 Infectious diseases: cryptosporidiosis in HIV?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.