Infectious diseases: diagnosis of enteric fever in the first week: 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 · Infectious diseases: diagnosis of enteric fever in the first week

Sample item

A 24-year-old man has had 4 days of stepladder fever, headache and constipation. He has relative bradycardia. Which investigation is most useful at this stage?

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

The answer and the reasoning

D. Blood culture

In the first week of enteric fever bacteraemia is highest, so blood culture is the most useful test. Widal antibodies appear after the first week and are unreliable in endemic regions. Stool culture becomes positive later.

Option by option

  • A. Urine culture

    Urine culture has a low yield in this infection.

  • B. Stool culture

    Stool culture is positive mainly from the second to third week.

  • C. Widal test

    Agglutinating antibodies are not yet reliable early and cross-react widely.

  • D. Blood culture (correct)

    Correct. Blood culture has the highest yield in the first week.

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 General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Blood culture. In the first week of enteric fever bacteraemia is highest, so blood culture is the most useful test.

Why is "Urine culture" not the answer?

Urine culture has a low yield in this infection.

Why is "Stool culture" not the answer?

Stool culture is positive mainly from the second to third week.

Why is "Widal test" not the answer?

Agglutinating antibodies are not yet reliable early and cross-react widely.

What concept does this question test?

It tests Infectious diseases: diagnosis of enteric fever in the first week in General Medicine. Widal antibodies appear after the first week and are unreliable in endemic regions. Stool culture becomes positive later.

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: diagnosis of enteric fever in the first week?

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.