Neurology: brain abscess: 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: brain abscess

Sample item

A young man with cyanotic congenital heart disease has fever, headache and a focal deficit. CT shows a 3 cm ring-enhancing lesion. Which is the appropriate management?

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

The answer and the reasoning

A. Stereotactic aspiration with intravenous ceftriaxone and metronidazole

Cyanotic heart disease with right-to-left shunting allows bacteria to bypass pulmonary filtration, predisposing to brain abscess, commonly with streptococci and anaerobes. Management is aspiration or drainage of lesions larger than about 2.5 cm and prolonged antibiotics covering streptococci and anaerobes. Lumbar puncture is dangerous because of raised intracranial pressure and herniation risk.

Option by option

  • A. Stereotactic aspiration with intravenous ceftriaxone and metronidazole (correct)

    Correct. Drainage plus broad antibiotics is standard.

  • B. Immediate lumbar puncture

    Lumbar puncture risks herniation with a mass lesion.

  • C. Corticosteroids alone

    Steroids alone do not treat the infection.

  • D. Oral albendazole alone

    Albendazole treats neurocysticercosis, not a pyogenic abscess.

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, Stereotactic aspiration with intravenous ceftriaxone and metronidazole. Cyanotic heart disease with right-to-left shunting allows bacteria to bypass pulmonary filtration, predisposing to brain abscess, commonly with streptococci and anaerobes.

Why is "Immediate lumbar puncture" not the answer?

Lumbar puncture risks herniation with a mass lesion.

Why is "Corticosteroids alone" not the answer?

Steroids alone do not treat the infection.

Why is "Oral albendazole alone" not the answer?

Albendazole treats neurocysticercosis, not a pyogenic abscess.

What concept does this question test?

It tests Neurology: brain abscess in General Medicine. Management is aspiration or drainage of lesions larger than about 2.5 cm and prolonged antibiotics covering streptococci and anaerobes. Lumbar puncture is dangerous because of raised intracranial pressure and herniation risk.

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: brain abscess?

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.