Gastrointestinal surgery: actinomycosis: practice question

A General Surgery 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

General Surgery · Gastrointestinal surgery: actinomycosis

Sample item

A man with poor dental hygiene has a chronic indurated swelling at the angle of the jaw with multiple discharging sinuses. The discharge contains yellow granules, and Gram stain shows branching filaments that are not acid-fast. What is the treatment?

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

The answer and the reasoning

C. Prolonged high-dose penicillin

Cervicofacial actinomycosis, caused by anaerobic Actinomyces, produces sulphur granules and responds to prolonged high-dose penicillin, with drainage of abscesses. The filaments are non-acid-fast, which excludes tuberculosis and Nocardia. It is not a malignancy.

Option by option

  • A. Wide excision with neck dissection

    The lesion is infective, so cancer surgery is wrong.

  • B. Antitubercular therapy

    The organism is not acid-fast, so antitubercular drugs are not indicated.

  • C. Prolonged high-dose penicillin (correct)

    Correct. Penicillin for many weeks is the treatment of choice.

  • D. Itraconazole

    Antifungal drugs do not treat this bacterial infection.

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.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Prolonged high-dose penicillin. Cervicofacial actinomycosis, caused by anaerobic Actinomyces, produces sulphur granules and responds to prolonged high-dose penicillin, with drainage of abscesses.

Why is "Wide excision with neck dissection" not the answer?

The lesion is infective, so cancer surgery is wrong.

Why is "Antitubercular therapy" not the answer?

The organism is not acid-fast, so antitubercular drugs are not indicated.

Why is "Itraconazole" not the answer?

Antifungal drugs do not treat this bacterial infection.

What concept does this question test?

It tests Gastrointestinal surgery: actinomycosis in General Surgery. The filaments are non-acid-fast, which excludes tuberculosis and Nocardia. It is not a malignancy.

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 Gastrointestinal surgery: actinomycosis?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.