A 28-year-old man from eastern Uttar Pradesh has a blood smear showing Plasmodium vivax. He has completed three days of chloroquine and is to receive primaquine 0.25 mg/kg daily for 14 days for radical cure. Which investigation must be done before starting primaquine?
- A G6PD enzyme level ✓
- B Serum bilirubin and liver enzymes
- C Complete blood count with platelets
- D Serum creatinine
Correct answer: A. G6PD enzyme level
Explanation
Primaquine causes haemolysis in glucose-6-phosphate dehydrogenase deficient individuals, so G6PD estimation is mandatory before the 14-day radical cure regimen for vivax malaria under national guidelines. Liver function abnormalities are not the limiting toxicity, anaemia from haemolysis is the consequence rather than a pretest, and creatinine has no role here. The best distractor, liver enzymes, addresses hepatic safety, which primaquine does not primarily threaten.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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