Communicable diseases: cutaneous anthrax: 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: cutaneous anthrax

Sample item

A 38-year-old man working in a hide-processing unit has a painless, itchy papule on the neck that became a vesicle and then a depressed black eschar surrounded by marked oedema. He has little fever and no history of work in scrub vegetation. Which diagnosis is most likely?

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

The answer and the reasoning

A. Cutaneous anthrax

Cutaneous anthrax follows contact with infected animal hides or wool and gives a painless papule that becomes a black eschar with striking surrounding oedema. It is an occupational zoonosis of hide, wool and animal handlers and is the commonest form of human anthrax.

Option by option

  • A. Cutaneous anthrax (correct)

    Correct. A painless black eschar with oedema after handling hides fits cutaneous anthrax.

  • B. Cutaneous leishmaniasis

    Cutaneous leishmaniasis gives a chronic nodule or ulcer after a sandfly bite, without an acute black eschar.

  • C. Scrub typhus

    Scrub typhus gives an eschar after a chigger bite in scrub vegetation, along with marked fever and lymphadenopathy.

  • D. Bubonic plague

    Bubonic plague presents with a painful, tender bubo and high fever rather than a black eschar.

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 PSM questions

Questions about this PSM question

What is the answer to this PSM question?

The best answer is A, Cutaneous anthrax. Cutaneous anthrax follows contact with infected animal hides or wool and gives a painless papule that becomes a black eschar with striking surrounding oedema.

Why is "Cutaneous leishmaniasis" not the answer?

Cutaneous leishmaniasis gives a chronic nodule or ulcer after a sandfly bite, without an acute black eschar.

Why is "Scrub typhus" not the answer?

Scrub typhus gives an eschar after a chigger bite in scrub vegetation, along with marked fever and lymphadenopathy.

Why is "Bubonic plague" not the answer?

Bubonic plague presents with a painful, tender bubo and high fever rather than a black eschar.

What concept does this question test?

It tests Communicable diseases: cutaneous anthrax in PSM. It is an occupational zoonosis of hide, wool and animal handlers and is the commonest form of human anthrax.

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 Communicable diseases: cutaneous anthrax?

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.