Parasitology: tropical pulmonary eosinophilia: 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.

Try it

Microbiology · Parasitology: tropical pulmonary eosinophilia

Sample item

A 30-year-old man from coastal Odisha has nocturnal cough and wheeze for 5 months with low-grade fever and weight loss. Absolute eosinophil count is 3500/µL, serum IgE and antifilarial antibody titres are very high, and no microfilariae are found in night blood films. The chest radiograph shows diffuse reticulonodular shadows, and he has not improved with bronchodilators. Which treatment is most appropriate?

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

The answer and the reasoning

B. Diethylcarbamazine

Tropical pulmonary eosinophilia is a hypersensitivity response of the lung to microfilariae of Wuchereria bancrofti or Brugia malayi, which are cleared from blood by immune action and trapped in the lungs. Blood films are therefore negative, whereas eosinophilia, high IgE and filarial antibodies are the clues. Diethylcarbamazine is the treatment, and untreated disease can cause pulmonary fibrosis.

Option by option

  • A. Inhaled salbutamol alone

    Bronchodilators alone give no benefit because the cause is parasitic and not simple asthma.

  • B. Diethylcarbamazine (correct)

    Diethylcarbamazine kills the filarial parasites that drive the hypersensitivity.

  • C. Antitubercular therapy

    Antitubercular therapy would treat a misdiagnosis, which is common when radiographs look like miliary tuberculosis.

  • D. Inhaled corticosteroid alone

    Inhaled corticosteroid does not eliminate the parasite and fails to prevent progression.

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 Microbiology questions

Questions about this Microbiology question

What is the answer to this Microbiology question?

The best answer is B, Diethylcarbamazine. Tropical pulmonary eosinophilia is a hypersensitivity response of the lung to microfilariae of Wuchereria bancrofti or Brugia malayi, which are cleared from blood by immune action and trapped in the lungs.

Why is "Inhaled salbutamol alone" not the answer?

Bronchodilators alone give no benefit because the cause is parasitic and not simple asthma.

Why is "Antitubercular therapy" not the answer?

Antitubercular therapy would treat a misdiagnosis, which is common when radiographs look like miliary tuberculosis.

Why is "Inhaled corticosteroid alone" not the answer?

Inhaled corticosteroid does not eliminate the parasite and fails to prevent progression.

What concept does this question test?

It tests Parasitology: tropical pulmonary eosinophilia in Microbiology. Blood films are therefore negative, whereas eosinophilia, high IgE and filarial antibodies are the clues. Diethylcarbamazine is the treatment, and untreated disease can cause pulmonary fibrosis.

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: tropical pulmonary eosinophilia?

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.