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 28-year-old woman has an episode of painful loss of vision in one eye that recovers, and 8 months later has tingling in the legs with an electric shock sensation on neck flexion. MRI shows periventricular ovoid lesions perpendicular to the ventricles. Which CSF finding is expected?

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

The answer and the reasoning

A. Oligoclonal IgG bands not present in serum

Multiple sclerosis involves multifocal demyelination separated in time and space. Intrathecal IgG synthesis produces oligoclonal bands in CSF in more than 90% of patients. The Lhermitte sign and optic neuritis are typical, and Dawson fingers are the ovoid periventricular lesions.

Option by option

  • A. Oligoclonal IgG bands not present in serum (correct)

    Correct. CSF-restricted oligoclonal bands are characteristic of multiple sclerosis.

  • B. Xanthochromia

    Xanthochromia indicates subarachnoid haemorrhage.

  • C. Markedly raised neutrophils with low glucose

    Neutrophilic pleocytosis with low glucose indicates bacterial meningitis.

  • D. Very high protein with normal cell count and flaccid weakness

    High protein with normal cells (albuminocytological dissociation) is the pattern of Guillain-Barre syndrome.

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, Oligoclonal IgG bands not present in serum. Multiple sclerosis involves multifocal demyelination separated in time and space.

Why is "Xanthochromia" not the answer?

Xanthochromia indicates subarachnoid haemorrhage.

Why is "Markedly raised neutrophils with low glucose" not the answer?

Neutrophilic pleocytosis with low glucose indicates bacterial meningitis.

Why is "Very high protein with normal cell count and flaccid weakness" not the answer?

High protein with normal cells (albuminocytological dissociation) is the pattern of Guillain-Barre syndrome.

What concept does this question test?

It tests Neurology in General Medicine. Intrathecal IgG synthesis produces oligoclonal bands in CSF in more than 90% of patients. The Lhermitte sign and optic neuritis are typical, and Dawson fingers are the ovoid periventricular lesions.

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.