Neurology: subacute combined degeneration: practice question

A General Medicine 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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General Medicine · Neurology: subacute combined degeneration

Sample item

A patient with B12 deficiency has spastic weakness, brisk knee reflexes, extensor plantars and loss of vibration and position sense. Which tracts are affected?

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

The answer and the reasoning

D. Dorsal columns and lateral corticospinal tracts

Subacute combined degeneration affects the dorsal columns and lateral corticospinal tracts, producing sensory ataxia and upper motor neuron signs, often with a peripheral neuropathy. Early B12 replacement may reverse changes. Folate must not be given alone.

Option by option

  • A. Spinocerebellar tracts only

    Spinocerebellar involvement occurs in Friedreich ataxia.

  • B. Anterior horn cells only

    Anterior horn cell loss is seen in motor neuron disease.

  • C. Spinothalamic tracts only

    Spinothalamic loss is not the pattern.

  • D. Dorsal columns and lateral corticospinal tracts (correct)

    Correct. Dorsal columns and corticospinal tracts are involved.

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 General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Dorsal columns and lateral corticospinal tracts. Subacute combined degeneration affects the dorsal columns and lateral corticospinal tracts, producing sensory ataxia and upper motor neuron signs, often with a peripheral neuropathy.

Why is "Spinocerebellar tracts only" not the answer?

Spinocerebellar involvement occurs in Friedreich ataxia.

Why is "Anterior horn cells only" not the answer?

Anterior horn cell loss is seen in motor neuron disease.

Why is "Spinothalamic tracts only" not the answer?

Spinothalamic loss is not the pattern.

What concept does this question test?

It tests Neurology: subacute combined degeneration in General Medicine. Early B12 replacement may reverse changes. Folate must not be given alone.

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 Neurology: subacute combined degeneration?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.