Parasitology: severe falciparum 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: severe falciparum malaria

Sample item

A 35-year-old man with Plasmodium falciparum malaria is drowsy, with a Glasgow Coma Scale score of 10 and 8% parasitaemia. Which regimen is appropriate?

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

The answer and the reasoning

A. Intravenous artesunate followed by a full course of oral artemisinin combination therapy

Severe malaria needs parenteral artesunate, which clears parasites faster and lowers mortality compared with quinine. Once the patient can take oral medication, a full course of an artemisinin combination is completed, and glucose is monitored. In India, intramuscular artemether or intravenous quinine are alternatives when artesunate is unavailable.

Option by option

  • A. Intravenous artesunate followed by a full course of oral artemisinin combination therapy (correct)

    Correct. IV artesunate followed by an oral ACT is the recommended treatment.

  • B. Oral artemether-lumefantrine alone

    Oral artemether-lumefantrine is suited to uncomplicated malaria and absorption is unreliable in severe disease.

  • C. Single-dose oral primaquine alone

    Primaquine is a gametocidal drug and has no role in treating severe asexual infection.

  • D. Oral chloroquine for 3 days

    Oral chloroquine is unreliable because of widespread falciparum resistance and cannot be given orally to a drowsy patient.

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 A, Intravenous artesunate followed by a full course of oral artemisinin combination therapy. Severe malaria needs parenteral artesunate, which clears parasites faster and lowers mortality compared with quinine.

Why is "Oral artemether-lumefantrine alone" not the answer?

Oral artemether-lumefantrine is suited to uncomplicated malaria and absorption is unreliable in severe disease.

Why is "Single-dose oral primaquine alone" not the answer?

Primaquine is a gametocidal drug and has no role in treating severe asexual infection.

Why is "Oral chloroquine for 3 days" not the answer?

Oral chloroquine is unreliable because of widespread falciparum resistance and cannot be given orally to a drowsy patient.

What concept does this question test?

It tests Parasitology: severe falciparum malaria in Microbiology. Once the patient can take oral medication, a full course of an artemisinin combination is completed, and glucose is monitored. In India, intramuscular artemether or intravenous quinine are alternatives when artesunate is unavailable.

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: severe falciparum 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.