Parasitology: Paragonimus lung fluke: 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: Paragonimus lung fluke

Sample item

A man from Manipur who eats raw freshwater crabs has a chronic cough with rusty brown sputum, eosinophilia and a cavitating lesion on chest radiograph. Sputum is negative for acid-fast bacilli. What would sputum microscopy most likely show?

ALarvae with a notched tailBOperculated, golden-brown eggsCEggs with a terminal spineDHooklets and protoscolices

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

The answer and the reasoning

B. Operculated, golden-brown eggs

Paragonimus species, the lung flukes, are acquired by eating raw or pickled crustaceans and mimic tuberculosis with haemoptysis. Operculated, golden-brown eggs are found in sputum or stool, and praziquantel is the drug of choice. The disease is reported in north-eastern India, where P. heterotremus is the species usually implicated, and P. westermani is the classic species elsewhere in Asia.

Option by option

A. Larvae with a notched tail
Larvae with notched tails are filariform larvae of Strongyloides and are not found in this setting.
B. Operculated, golden-brown eggs (correct)
Operculated golden-brown eggs in sputum are diagnostic of lung fluke infection.
C. Eggs with a terminal spine
Terminal-spined eggs belong to Schistosoma haematobium and are found in urine.
D. Hooklets and protoscolices
Hooklets and protoscolices are found in hydatid cyst fluid.

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 B, Operculated, golden-brown eggs. Paragonimus species, the lung flukes, are acquired by eating raw or pickled crustaceans and mimic tuberculosis with haemoptysis.

Why is "Larvae with a notched tail" not the answer?

Larvae with notched tails are filariform larvae of Strongyloides and are not found in this setting.

Why is "Eggs with a terminal spine" not the answer?

Terminal-spined eggs belong to Schistosoma haematobium and are found in urine.

Why is "Hooklets and protoscolices" not the answer?

Hooklets and protoscolices are found in hydatid cyst fluid.

What concept does this question test?

It tests Parasitology: Paragonimus lung fluke in Microbiology. Operculated, golden-brown eggs are found in sputum or stool, and praziquantel is the drug of choice. The disease is reported in north-eastern India, where P. heterotremus is the species usually implicated, and P. westermani is the classic species elsewhere in Asia.

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: Paragonimus lung fluke?

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.