Neurology: 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

Sample item

A chronic alcohol user is brought in confused, with nystagmus and an unsteady gait. What should be given first?

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

The answer and the reasoning

C. Intravenous thiamine

This is Wernicke encephalopathy: confusion, ophthalmoplegia and ataxia from thiamine deficiency. Thiamine should be given before or with glucose, because glucose alone can precipitate or worsen the condition.

Option by option

  • A. Intravenous lorazepam

    A benzodiazepine does not treat the cause, though it may be needed for withdrawal.

  • B. Intravenous naloxone

    Naloxone is for opioid overdose.

  • C. Intravenous thiamine (correct)

    Correct. Treat promptly to prevent Korsakoff syndrome.

  • D. Intravenous glucose alone

    Glucose alone uses up remaining thiamine and may worsen it.

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 C, Intravenous thiamine. This is Wernicke encephalopathy: confusion, ophthalmoplegia and ataxia from thiamine deficiency.

Why is "Intravenous lorazepam" not the answer?

A benzodiazepine does not treat the cause, though it may be needed for withdrawal.

Why is "Intravenous naloxone" not the answer?

Naloxone is for opioid overdose.

Why is "Intravenous glucose alone" not the answer?

Glucose alone uses up remaining thiamine and may worsen it.

What concept does this question test?

It tests Neurology in General Medicine. Thiamine should be given before or with glucose, because glucose alone can precipitate or worsen the condition.

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?

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.