Hypertensive disorders: posterior reversible encephalopathy: practice question

A OBG 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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OBG · Hypertensive disorders: posterior reversible encephalopathy

Sample item

A woman with severe pre-eclampsia has a seizure, followed by headache, visual blurring and confusion. MRI shows bilateral parieto-occipital hyperintensities on FLAIR sequences. What is the diagnosis?

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

The answer and the reasoning

C. Posterior reversible encephalopathy syndrome

Posterior reversible encephalopathy syndrome results from failure of cerebral autoregulation and endothelial dysfunction, producing vasogenic oedema predominantly in the parieto-occipital regions. It presents with seizures, headache, visual disturbance and confusion in severe hypertension, and it often reverses with blood pressure control and magnesium. MRI is the best imaging modality.

Option by option

  • A. Multiple sclerosis

    Multiple sclerosis lesions are periventricular and not related to hypertension.

  • B. Subarachnoid haemorrhage

    Subarachnoid haemorrhage shows blood on CT with thunderclap headache.

  • C. Posterior reversible encephalopathy syndrome (correct)

    Correct. Bilateral parieto-occipital oedema with seizures and visual symptoms in pre-eclampsia is PRES.

  • D. Cerebral venous sinus thrombosis

    Venous thrombosis shows a filling defect on venography and not this posterior pattern.

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 OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Posterior reversible encephalopathy syndrome. Posterior reversible encephalopathy syndrome results from failure of cerebral autoregulation and endothelial dysfunction, producing vasogenic oedema predominantly in the parieto-occipital regions.

Why is "Multiple sclerosis" not the answer?

Multiple sclerosis lesions are periventricular and not related to hypertension.

Why is "Subarachnoid haemorrhage" not the answer?

Subarachnoid haemorrhage shows blood on CT with thunderclap headache.

Why is "Cerebral venous sinus thrombosis" not the answer?

Venous thrombosis shows a filling defect on venography and not this posterior pattern.

What concept does this question test?

It tests Hypertensive disorders: posterior reversible encephalopathy in OBG. It presents with seizures, headache, visual disturbance and confusion in severe hypertension, and it often reverses with blood pressure control and magnesium. MRI is the best imaging modality.

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 Hypertensive disorders: posterior reversible encephalopathy?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG 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.