Trauma: raised intracranial pressure: practice question

A General Surgery 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 Surgery · Trauma: raised intracranial pressure

Sample item

A patient with a head injury develops hypertension, bradycardia and irregular respiration. Which immediate measure is appropriate?

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

The answer and the reasoning

D. Head-up position at 30 degrees, airway control and osmotherapy such as mannitol

Cushing reflex of hypertension, bradycardia and irregular breathing indicates critically raised intracranial pressure and impending herniation. Initial measures include securing the airway, elevating the head, avoiding hypotension and hypoxia, and giving mannitol or hypertonic saline, followed by urgent CT and neurosurgical care. Lumbar puncture is dangerous because it can precipitate herniation.

Option by option

  • A. Giving sedatives only

    Sedation alone does not treat the cause and masks neurological signs.

  • B. Lying flat with fluids

    Lying flat raises venous pressure in the head.

  • C. Lumbar puncture

    Lumbar puncture risks coning.

  • D. Head-up position at 30 degrees, airway control and osmotherapy such as mannitol (correct)

    Correct. These measures lower ICP while definitive care is arranged.

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.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Head-up position at 30 degrees, airway control and osmotherapy such as mannitol. Cushing reflex of hypertension, bradycardia and irregular breathing indicates critically raised intracranial pressure and impending herniation.

Why is "Giving sedatives only" not the answer?

Sedation alone does not treat the cause and masks neurological signs.

Why is "Lying flat with fluids" not the answer?

Lying flat raises venous pressure in the head.

Why is "Lumbar puncture" not the answer?

Lumbar puncture risks coning.

What concept does this question test?

It tests Trauma: raised intracranial pressure in General Surgery. Initial measures include securing the airway, elevating the head, avoiding hypotension and hypoxia, and giving mannitol or hypertonic saline, followed by urgent CT and neurosurgical care. Lumbar puncture is dangerous because it can precipitate herniation.

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 Trauma: raised intracranial pressure?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.