Parasitology: Strongyloides screening before steroids: 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.

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Microbiology · Parasitology: Strongyloides screening before steroids

Sample item

A 50-year-old man from rural Bangladesh has long-standing eosinophilia and intermittent itchy tracks over the buttocks. High-dose prednisolone is planned for vasculitis. Stool wet mounts are negative. What is the best step before starting steroids?

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

The answer and the reasoning

B. Strongyloides serology and ivermectin if positive

Strongyloides stool sensitivity is poor because larval output is low, and corticosteroids can trigger fatal hyperinfection. In an endemic-area patient, serology is used and ivermectin is given if positive, or often empirically.

Option by option

  • A. Single-dose albendazole given empirically

    Albendazole is less effective against Strongyloides than ivermectin.

  • B. Strongyloides serology and ivermectin if positive (correct)

    Correct. Serology plus ivermectin addresses the risk of hyperinfection under steroids.

  • C. Proceed because a negative stool excludes infection

    A negative stool does not exclude infection because larval output is low and intermittent.

  • D. Repeated Kato-Katz smears alone

    Kato-Katz is designed for eggs and misses Strongyloides larvae.

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 Microbiology question

What is the answer to this Microbiology question?

The best answer is B, Strongyloides serology and ivermectin if positive. Strongyloides stool sensitivity is poor because larval output is low, and corticosteroids can trigger fatal hyperinfection.

Why is "Single-dose albendazole given empirically" not the answer?

Albendazole is less effective against Strongyloides than ivermectin.

Why is "Proceed because a negative stool excludes infection" not the answer?

A negative stool does not exclude infection because larval output is low and intermittent.

Why is "Repeated Kato-Katz smears alone" not the answer?

Kato-Katz is designed for eggs and misses Strongyloides larvae.

What concept does this question test?

It tests Parasitology: Strongyloides screening before steroids in Microbiology. In an endemic-area patient, serology is used and ivermectin is given if positive, or often empirically.

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: Strongyloides screening before steroids?

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.