Gastroenterology and hepatology: Candida oesophagitis: 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.

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General Medicine · Gastroenterology and hepatology: Candida oesophagitis

Sample item

A 34-year-old man with HIV and a CD4 count of 40 per microlitre has odynophagia and white plaques on the tongue. Endoscopy shows creamy linear plaques in the oesophagus that leave red mucosa when wiped off. What is the best treatment?

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

The answer and the reasoning

C. Oral fluconazole

In an immunosuppressed patient with oral thrush and odynophagia, Candida oesophagitis is the usual cause and can be treated empirically with oral fluconazole. Endoscopy is needed if symptoms persist. Herpes and cytomegalovirus cause ulcers rather than plaques.

Option by option

  • A. Oral aciclovir

    Aciclovir treats herpes oesophagitis, which gives shallow punched-out ulcers.

  • B. Intravenous ganciclovir

    Ganciclovir treats cytomegalovirus oesophagitis, which gives large linear ulcers.

  • C. Oral fluconazole (correct)

    Correct. Fluconazole is first-line treatment for oesophageal candidiasis.

  • D. Oral albendazole

    Albendazole is an anthelmintic with no action against fungi.

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 General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Oral fluconazole. In an immunosuppressed patient with oral thrush and odynophagia, Candida oesophagitis is the usual cause and can be treated empirically with oral fluconazole.

Why is "Oral aciclovir" not the answer?

Aciclovir treats herpes oesophagitis, which gives shallow punched-out ulcers.

Why is "Intravenous ganciclovir" not the answer?

Ganciclovir treats cytomegalovirus oesophagitis, which gives large linear ulcers.

Why is "Oral albendazole" not the answer?

Albendazole is an anthelmintic with no action against fungi.

What concept does this question test?

It tests Gastroenterology and hepatology: Candida oesophagitis in General Medicine. Endoscopy is needed if symptoms persist. Herpes and cytomegalovirus cause ulcers rather than plaques.

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 Gastroenterology and hepatology: Candida oesophagitis?

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.