Neurology: posterior reversible encephalopathy syndrome: 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: posterior reversible encephalopathy syndrome

Sample item

A 28-year-old woman four days after delivery has blood pressure 190/110 mmHg, headache, visual blurring and a seizure. MRI shows bilateral posterior white matter FLAIR hyperintensity without restricted diffusion. What is the diagnosis?

AAcute disseminated encephalomyelitisBCerebral venous sinus thrombosis with infarctionCPosterior reversible encephalopathy syndromeDPosterior circulation infarct

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

The answer and the reasoning

C. Posterior reversible encephalopathy syndrome

PRES follows severe hypertension, eclampsia or immunosuppressant use and shows vasogenic oedema in the parieto-occipital white matter. It is usually reversible with blood pressure control and removal of the trigger. Lack of restricted diffusion argues against infarction.

Option by option

A. Acute disseminated encephalomyelitis
ADEM follows an infection with multifocal lesions rather than posterior predominance.
B. Cerebral venous sinus thrombosis with infarction
Venous thrombosis shows venous infarcts with haemorrhage and a filling defect in a sinus.
C. Posterior reversible encephalopathy syndrome (correct)
Correct. Hypertension with seizures and reversible posterior vasogenic oedema defines PRES.
D. Posterior circulation infarct
A posterior infarct shows restricted diffusion in a vascular territory.

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.

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Posterior reversible encephalopathy syndrome. PRES follows severe hypertension, eclampsia or immunosuppressant use and shows vasogenic oedema in the parieto-occipital white matter.

Why is "Acute disseminated encephalomyelitis" not the answer?

ADEM follows an infection with multifocal lesions rather than posterior predominance.

Why is "Cerebral venous sinus thrombosis with infarction" not the answer?

Venous thrombosis shows venous infarcts with haemorrhage and a filling defect in a sinus.

Why is "Posterior circulation infarct" not the answer?

A posterior infarct shows restricted diffusion in a vascular territory.

What concept does this question test?

It tests Neurology: posterior reversible encephalopathy syndrome in General Medicine. It is usually reversible with blood pressure control and removal of the trigger. Lack of restricted diffusion argues against infarction.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: posterior reversible encephalopathy syndrome?

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.