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 pernicious anemia has impaired vibration sense, gait ataxia, spasticity, and macrocytosis. Which spinal pathways are affected?

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

The answer and the reasoning

A. Dorsal columns and lateral corticospinal tracts

Vitamin B12 deficiency can cause subacute combined degeneration with demyelination of posterior columns and lateral corticospinal tracts. Neurologic injury may persist if treatment is delayed.

Option by option

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

    Correct. This tract combination explains proprioceptive loss and spasticity.

  • B. Anterior horn cells only

    Anterior horn-cell disease gives lower-motor-neuron signs.

  • C. Spinothalamic tracts only

    Spinothalamic tract loss causes pain and temperature deficits.

  • D. Cerebellar cortex only

    Cerebellar lesions do not cause macrocytosis.

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 A, Dorsal columns and lateral corticospinal tracts. Vitamin B12 deficiency can cause subacute combined degeneration with demyelination of posterior columns and lateral corticospinal tracts.

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

Anterior horn-cell disease gives lower-motor-neuron signs.

Why is "Spinothalamic tracts only" not the answer?

Spinothalamic tract loss causes pain and temperature deficits.

Why is "Cerebellar cortex only" not the answer?

Cerebellar lesions do not cause macrocytosis.

What concept does this question test?

It tests Neurology: subacute combined degeneration in General Medicine. Neurologic injury may persist if treatment is delayed.

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.