Neuroimaging: practice question

A Radiology 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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Radiology · Neuroimaging

Sample item

A 35-year-old man has fever, headache, confusion and a focal seizure. MRI shows hyperintensity on T2 and FLAIR in the right medial temporal lobe and insula, sparing the basal ganglia. Which treatment should be started immediately?

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

The answer and the reasoning

A. Intravenous acyclovir

Herpes simplex encephalitis has a predilection for the temporal lobes, orbitofrontal cortex and insula, often asymmetrically. Empirical intravenous acyclovir should be started at once without waiting for PCR confirmation of CSF. Delay increases mortality and neurological sequelae.

Option by option

  • A. Intravenous acyclovir (correct)

    Correct. Acyclovir is the treatment for HSV encephalitis.

  • B. Intravenous amphotericin B

    Amphotericin B is used for cryptococcal or other fungal infections.

  • C. Antitubercular therapy

    Antitubercular therapy is used for tuberculous meningitis, which causes basal enhancement and hydrocephalus.

  • D. Intravenous ganciclovir

    Ganciclovir is used for cytomegalovirus infections.

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 Radiology questions

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is A, Intravenous acyclovir. Herpes simplex encephalitis has a predilection for the temporal lobes, orbitofrontal cortex and insula, often asymmetrically.

Why is "Intravenous amphotericin B" not the answer?

Amphotericin B is used for cryptococcal or other fungal infections.

Why is "Antitubercular therapy" not the answer?

Antitubercular therapy is used for tuberculous meningitis, which causes basal enhancement and hydrocephalus.

Why is "Intravenous ganciclovir" not the answer?

Ganciclovir is used for cytomegalovirus infections.

What concept does this question test?

It tests Neuroimaging in Radiology. Empirical intravenous acyclovir should be started at once without waiting for PCR confirmation of CSF. Delay increases mortality and neurological sequelae.

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 Neuroimaging?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology 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.