Neurology: 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

Sample item

A 72-year-old man has progressive gait disturbance with short magnetic steps, urinary urgency and memory decline over several months. CT shows enlarged ventricles without prominent cortical atrophy. Which treatment is most likely to help?

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

The answer and the reasoning

A. Ventriculoperitoneal shunt

Normal pressure hydrocephalus presents with the triad of gait apraxia, urinary incontinence and dementia, and imaging shows ventriculomegaly out of proportion to atrophy. Large-volume lumbar puncture can predict response. Shunting is the definitive treatment and gait usually improves first.

Option by option

  • A. Ventriculoperitoneal shunt (correct)

    Correct. CSF diversion treats the potentially reversible dementia.

  • B. Anticoagulation

    Anticoagulation has no role as there is no thromboembolic cause.

  • C. Levodopa-carbidopa

    Levodopa gives little benefit because the gait disorder is not a nigrostriatal dopamine deficiency.

  • D. Donepezil alone

    Cholinesterase inhibitors do not treat the cause and do not improve gait.

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 General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Ventriculoperitoneal shunt. Normal pressure hydrocephalus presents with the triad of gait apraxia, urinary incontinence and dementia, and imaging shows ventriculomegaly out of proportion to atrophy.

Why is "Anticoagulation" not the answer?

Anticoagulation has no role as there is no thromboembolic cause.

Why is "Levodopa-carbidopa" not the answer?

Levodopa gives little benefit because the gait disorder is not a nigrostriatal dopamine deficiency.

Why is "Donepezil alone" not the answer?

Cholinesterase inhibitors do not treat the cause and do not improve gait.

What concept does this question test?

It tests Neurology in General Medicine. Large-volume lumbar puncture can predict response. Shunting is the definitive treatment and gait usually improves first.

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?

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.