Paediatric infections: hydrocephalus in tubercular meningitis: practice question

A Pediatrics 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.

Try it

Pediatrics · Paediatric infections: hydrocephalus in tubercular meningitis

Sample item

A child with tubercular meningitis develops a bulging fontanelle and ventricular dilatation on CT. Which mechanism most commonly produces the hydrocephalus?

AThrombosis of the superior sagittal sinusBCongenital aqueductal stenosisCBasal exudate impairing CSF flow and absorption at the basal cisternsDOverproduction of CSF by the choroid plexus

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

The answer and the reasoning

C. Basal exudate impairing CSF flow and absorption at the basal cisterns

Thick gelatinous exudate at the base of the brain blocks the cisterns and arachnoid villi, giving communicating hydrocephalus, and can also obstruct the ventricular outflow. Ventriculoperitoneal shunting may be needed in addition to antitubercular drugs and steroids.

Option by option

A. Thrombosis of the superior sagittal sinus
Venous thrombosis is not the usual mechanism of TBM hydrocephalus.
B. Congenital aqueductal stenosis
Aqueductal stenosis is congenital and unrelated to TBM.
C. Basal exudate impairing CSF flow and absorption at the basal cisterns (correct)
Correct. Basal exudate interferes with CSF circulation and absorption.
D. Overproduction of CSF by the choroid plexus
Choroid plexus overproduction is a rare cause and is not the mechanism in TBM.

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 Pediatrics question

What is the answer to this Pediatrics question?

The best answer is C, Basal exudate impairing CSF flow and absorption at the basal cisterns. Thick gelatinous exudate at the base of the brain blocks the cisterns and arachnoid villi, giving communicating hydrocephalus, and can also obstruct the ventricular outflow.

Why is "Thrombosis of the superior sagittal sinus" not the answer?

Venous thrombosis is not the usual mechanism of TBM hydrocephalus.

Why is "Congenital aqueductal stenosis" not the answer?

Aqueductal stenosis is congenital and unrelated to TBM.

Why is "Overproduction of CSF by the choroid plexus" not the answer?

Choroid plexus overproduction is a rare cause and is not the mechanism in TBM.

What concept does this question test?

It tests Paediatric infections: hydrocephalus in tubercular meningitis in Pediatrics. Ventriculoperitoneal shunting may be needed in addition to antitubercular drugs and steroids.

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 Paediatric infections: hydrocephalus in tubercular meningitis?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.