Parasitology: artemisinin resistance marker: 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: artemisinin resistance marker

Sample item

In Southeast Asia, falciparum malaria shows delayed parasite clearance after artesunate-based therapy. Mutations in which gene are the molecular marker of this partial artemisinin resistance?

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

The answer and the reasoning

D. kelch13 propeller domain gene

Mutations in the kelch13 propeller domain of Plasmodium falciparum are the validated marker of delayed clearance after artemisinins. The other genes are associated with chloroquine, antifolate and atovaquone resistance.

Option by option

  • A. mitochondrial cytochrome b gene

    Cytochrome b mutations confer resistance to atovaquone.

  • B. pfcrt chloroquine resistance transporter

    pfcrt mutations are associated with chloroquine resistance.

  • C. dhfr dihydrofolate reductase gene

    dhfr mutations confer resistance to pyrimethamine and related antifolates.

  • D. kelch13 propeller domain gene (correct)

    Correct. kelch13 mutations mark partial artemisinin resistance.

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 D, kelch13 propeller domain gene. Mutations in the kelch13 propeller domain of Plasmodium falciparum are the validated marker of delayed clearance after artemisinins.

Why is "mitochondrial cytochrome b gene" not the answer?

Cytochrome b mutations confer resistance to atovaquone.

Why is "pfcrt chloroquine resistance transporter" not the answer?

pfcrt mutations are associated with chloroquine resistance.

Why is "dhfr dihydrofolate reductase gene" not the answer?

dhfr mutations confer resistance to pyrimethamine and related antifolates.

What concept does this question test?

It tests Parasitology: artemisinin resistance marker in Microbiology. The other genes are associated with chloroquine, antifolate and atovaquone resistance.

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 Parasitology: artemisinin resistance marker?

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.