Infectious diseases: invasive pulmonary aspergillosis: 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: invasive pulmonary aspergillosis

Sample item

A patient with acute leukaemia has had 12 days of neutropenia with persistent fever on broad-spectrum antibiotics. CT chest shows nodules surrounded by ground-glass haloes, and serum galactomannan is positive. What is the drug of choice?

ACaspofunginBVoriconazoleCNystatinDFluconazole

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

The answer and the reasoning

B. Voriconazole

Prolonged neutropenia with halo-sign nodules and positive galactomannan indicates invasive aspergillosis. Voriconazole is the first-line agent, and fluconazole has no activity against moulds.

Option by option

A. Caspofungin
Caspofungin, an echinocandin, is used as salvage or in combination, not as preferred sole first-line therapy.
B. Voriconazole (correct)
Correct. Voriconazole is the preferred primary therapy for invasive aspergillosis.
C. Nystatin
Nystatin is a topical agent and is not absorbed.
D. Fluconazole
Fluconazole lacks activity against Aspergillus species.

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, Voriconazole. Prolonged neutropenia with halo-sign nodules and positive galactomannan indicates invasive aspergillosis.

Why is "Caspofungin" not the answer?

Caspofungin, an echinocandin, is used as salvage or in combination, not as preferred sole first-line therapy.

Why is "Nystatin" not the answer?

Nystatin is a topical agent and is not absorbed.

Why is "Fluconazole" not the answer?

Fluconazole lacks activity against Aspergillus species.

What concept does this question test?

It tests Infectious diseases: invasive pulmonary aspergillosis in General Medicine. Voriconazole is the first-line agent, and fluconazole has no activity against moulds.

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: invasive pulmonary aspergillosis?

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.