Parasitology: hyperreactive malarial splenomegaly: practice question

A Microbiology 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

Microbiology · Parasitology: hyperreactive malarial splenomegaly

Sample item

A woman from a hyperendemic malaria area has massive splenomegaly, anaemia and very high serum IgM. Smears show no parasites, and the liver biopsy shows sinusoidal lymphocytosis. Which treatment is most suitable?

ASplenectomy as first-line treatmentBHigh-dose corticosteroidsCLong-term antimalarial prophylaxisDAntituberculous therapy

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

The answer and the reasoning

C. Long-term antimalarial prophylaxis

This picture is hyperreactive malarial (tropical) splenomegaly, an exaggerated immune response to repeated malaria with high IgM and few or no parasites. It responds to prolonged antimalarial prophylaxis, and the spleen gradually shrinks.

Option by option

A. Splenectomy as first-line treatment
Splenectomy is not first-line and exposes the patient to overwhelming infection.
B. High-dose corticosteroids
Corticosteroids do not treat the underlying immune stimulation and are not indicated.
C. Long-term antimalarial prophylaxis (correct)
Correct. Prolonged antimalarial therapy or prophylaxis reduces the antigenic drive and the spleen regresses.
D. Antituberculous therapy
Nothing in this picture suggests tuberculosis, so antituberculous therapy is unwarranted.

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 Microbiology question

What is the answer to this Microbiology question?

The best answer is C, Long-term antimalarial prophylaxis. This picture is hyperreactive malarial (tropical) splenomegaly, an exaggerated immune response to repeated malaria with high IgM and few or no parasites.

Why is "Splenectomy as first-line treatment" not the answer?

Splenectomy is not first-line and exposes the patient to overwhelming infection.

Why is "High-dose corticosteroids" not the answer?

Corticosteroids do not treat the underlying immune stimulation and are not indicated.

Why is "Antituberculous therapy" not the answer?

Nothing in this picture suggests tuberculosis, so antituberculous therapy is unwarranted.

What concept does this question test?

It tests Parasitology: hyperreactive malarial splenomegaly in Microbiology. It responds to prolonged antimalarial prophylaxis, and the spleen gradually shrinks.

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 Parasitology: hyperreactive malarial splenomegaly?

Make a one-line identity card for each organism: shape and stain, defining test, toxin, disease and drug. Then use the flashcards and the other Microbiology 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.