Parasitology: hypoglycaemia in severe malaria: 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: hypoglycaemia in severe malaria

Sample item

A pregnant woman with severe falciparum malaria on intravenous quinine becomes sweaty, drowsy and convulses. Blood glucose is 28 mg/dL. Which mechanism contributes mainly?

ADestruction of pancreatic beta cells by merozoitesBAdrenal haemorrhage causing cortisol deficiencyCFailure of intestinal glucose absorption from gut oedemaDQuinine-stimulated insulin secretion and parasite glucose use

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

The answer and the reasoning

D. Quinine-stimulated insulin secretion and parasite glucose use

Hypoglycaemia in severe malaria results from parasite glucose consumption, impaired hepatic gluconeogenesis and, with quinine, hyperinsulinaemia from stimulated pancreatic secretion. Pregnant women are especially susceptible, so glucose is monitored regularly.

Option by option

A. Destruction of pancreatic beta cells by merozoites
Merozoites do not destroy pancreatic beta cells.
B. Adrenal haemorrhage causing cortisol deficiency
Adrenal haemorrhage is a feature of meningococcaemia, not malaria.
C. Failure of intestinal glucose absorption from gut oedema
Gut oedema is not the usual cause of malarial hypoglycaemia.
D. Quinine-stimulated insulin secretion and parasite glucose use (correct)
Correct. Quinine-induced hyperinsulinaemia and parasite consumption lower blood glucose.

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 D, Quinine-stimulated insulin secretion and parasite glucose use. Hypoglycaemia in severe malaria results from parasite glucose consumption, impaired hepatic gluconeogenesis and, with quinine, hyperinsulinaemia from stimulated pancreatic secretion.

Why is "Destruction of pancreatic beta cells by merozoites" not the answer?

Merozoites do not destroy pancreatic beta cells.

Why is "Adrenal haemorrhage causing cortisol deficiency" not the answer?

Adrenal haemorrhage is a feature of meningococcaemia, not malaria.

Why is "Failure of intestinal glucose absorption from gut oedema" not the answer?

Gut oedema is not the usual cause of malarial hypoglycaemia.

What concept does this question test?

It tests Parasitology: hypoglycaemia in severe malaria in Microbiology. Pregnant women are especially susceptible, so glucose is monitored regularly.

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: hypoglycaemia in severe malaria?

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.