Neuro-ophthalmology: practice question

A Ophthalmology 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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Ophthalmology · Neuro-ophthalmology

Sample item

An obese young woman has daily headaches and transient visual obscurations. Both optic discs are swollen, visual acuity is normal and MRI of the brain and venography are normal. Lumbar puncture opening pressure is raised with normal cerebrospinal fluid composition. Which drug is used as first-line medical therapy?

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

The answer and the reasoning

B. Acetazolamide

Idiopathic intracranial hypertension typically affects obese women of childbearing age. Papilloedema threatens vision, so treatment aims at weight loss and lowering CSF production with acetazolamide, with optic nerve sheath fenestration or shunting for progressive visual loss.

Option by option

  • A. Oral amitriptyline

    Amitriptyline may be used for headache but does not treat raised intracranial pressure and causes weight gain.

  • B. Acetazolamide (correct)

    Correct. Acetazolamide reduces CSF production.

  • C. Oral prednisolone

    Steroids are not first-line and can cause weight gain.

  • D. Intravenous mannitol on a long-term basis

    Mannitol is used only for short-term emergency reduction of pressure.

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 Ophthalmology questions

Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is B, Acetazolamide. Idiopathic intracranial hypertension typically affects obese women of childbearing age.

Why is "Oral amitriptyline" not the answer?

Amitriptyline may be used for headache but does not treat raised intracranial pressure and causes weight gain.

Why is "Oral prednisolone" not the answer?

Steroids are not first-line and can cause weight gain.

Why is "Intravenous mannitol on a long-term basis" not the answer?

Mannitol is used only for short-term emergency reduction of pressure.

What concept does this question test?

It tests Neuro-ophthalmology in Ophthalmology. Papilloedema threatens vision, so treatment aims at weight loss and lowering CSF production with acetazolamide, with optic nerve sheath fenestration or shunting for progressive visual loss.

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 Neuro-ophthalmology?

Group the red eye by what to examine and what the pupil does. Then use the flashcards and the other Ophthalmology 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.