Endocrine: adrenal: practice question

A Pathology 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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Pathology · Endocrine: adrenal

Sample item

A 6-year-old boy has fever, a spreading purpuric rash and hypotension unresponsive to fluids. He dies within hours, and autopsy shows bilateral massive adrenal haemorrhage. Which organism is most likely responsible?

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

The answer and the reasoning

D. Neisseria meningitidis

Waterhouse-Friderichsen syndrome is acute adrenal failure from bilateral adrenal haemorrhage, classically in fulminant meningococcaemia with DIC and endotoxic shock. Tuberculosis causes chronic adrenal destruction (Addison disease), not acute haemorrhage. It can also occur with other sepsis such as pneumococcus.

Option by option

  • A. Staphylococcus aureus

    Staphylococcus aureus can cause toxic shock but is not the classic cause of this syndrome.

  • B. Mycobacterium tuberculosis

    Tuberculosis causes chronic caseating destruction of the adrenals.

  • C. Salmonella typhi

    Typhoid causes enteric fever with intestinal ulceration.

  • D. Neisseria meningitidis (correct)

    Correct. Meningococcal sepsis with DIC is the classic cause.

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 Pathology question

What is the answer to this Pathology question?

The best answer is D, Neisseria meningitidis. Waterhouse-Friderichsen syndrome is acute adrenal failure from bilateral adrenal haemorrhage, classically in fulminant meningococcaemia with DIC and endotoxic shock.

Why is "Staphylococcus aureus" not the answer?

Staphylococcus aureus can cause toxic shock but is not the classic cause of this syndrome.

Why is "Mycobacterium tuberculosis" not the answer?

Tuberculosis causes chronic caseating destruction of the adrenals.

Why is "Salmonella typhi" not the answer?

Typhoid causes enteric fever with intestinal ulceration.

What concept does this question test?

It tests Endocrine: adrenal in Pathology. Tuberculosis causes chronic adrenal destruction (Addison disease), not acute haemorrhage. It can also occur with other sepsis such as pneumococcus.

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 Endocrine: adrenal?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology 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.