Spinal cord injury: methylprednisolone: practice question

A Orthopaedics 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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Orthopaedics · Spinal cord injury: methylprednisolone

Sample item

A 30-year-old has a cervical spinal cord injury after a diving accident. Which statement about high-dose methylprednisolone in acute spinal cord injury reflects current practice?

AIt replaces the need for decompressionBIt cures complete injuriesCIt is not routinely recommended because the benefit is doubtful and complications such as infection are increasedDIt is mandatory within 8 hours for all patients

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

The answer and the reasoning

C. It is not routinely recommended because the benefit is doubtful and complications such as infection are increased

High-dose methylprednisolone was once widely used after the NASCIS trials. Re-analysis showed marginal benefit, with increased risks of infection, gastrointestinal bleeding and pneumonia, so it is no longer routinely recommended. Early resuscitation, immobilisation and decompression where indicated remain the priorities.

Option by option

A. It replaces the need for decompression
Surgical decompression and stabilisation are not replaced by steroids.
B. It cures complete injuries
It does not reverse a complete injury.
C. It is not routinely recommended because the benefit is doubtful and complications such as infection are increased (correct)
Correct. Routine use is no longer recommended because benefit is doubtful and risks are real.
D. It is mandatory within 8 hours for all patients
It is not mandatory in current guidelines.

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 Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, It is not routinely recommended because the benefit is doubtful and complications such as infection are increased. High-dose methylprednisolone was once widely used after the NASCIS trials.

Why is "It replaces the need for decompression" not the answer?

Surgical decompression and stabilisation are not replaced by steroids.

Why is "It cures complete injuries" not the answer?

It does not reverse a complete injury.

Why is "It is mandatory within 8 hours for all patients" not the answer?

It is not mandatory in current guidelines.

What concept does this question test?

It tests Spinal cord injury: methylprednisolone in Orthopaedics. Re-analysis showed marginal benefit, with increased risks of infection, gastrointestinal bleeding and pneumonia, so it is no longer routinely recommended. Early resuscitation, immobilisation and decompression where indicated remain the priorities.

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 Spinal cord injury: methylprednisolone?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics 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.