Injuries and wounds: repeated head trauma: practice question

A Forensic 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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Forensic Medicine · Injuries and wounds: repeated head trauma

Sample item

A retired boxer in his fifties has progressive memory loss, parkinsonism and slurred speech. Brain examination shows perivascular tau deposition and a fenestrated cavum septum pellucidum. What is the diagnosis?

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

The answer and the reasoning

B. Chronic traumatic encephalopathy

Repeated head injuries cause chronic traumatic encephalopathy, with perivascular tau, cavum septum changes and a mixed cognitive and motor syndrome. Alzheimer disease features diffuse amyloid plaques and tangles. The history of boxing is the key.

Option by option

  • A. Alzheimer disease

    Alzheimer disease has diffuse plaques and tangles and no link to repeated trauma.

  • B. Chronic traumatic encephalopathy (correct)

    Correct. Perivascular tau after repeated head blows defines chronic traumatic encephalopathy.

  • C. Creutzfeldt-Jakob disease

    Creutzfeldt-Jakob disease is a rapid prion dementia with spongiform change.

  • D. Normal pressure hydrocephalus

    Normal pressure hydrocephalus produces gait disturbance, urinary incontinence and dementia with enlarged ventricles.

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 Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is B, Chronic traumatic encephalopathy. Repeated head injuries cause chronic traumatic encephalopathy, with perivascular tau, cavum septum changes and a mixed cognitive and motor syndrome.

Why is "Alzheimer disease" not the answer?

Alzheimer disease has diffuse plaques and tangles and no link to repeated trauma.

Why is "Creutzfeldt-Jakob disease" not the answer?

Creutzfeldt-Jakob disease is a rapid prion dementia with spongiform change.

Why is "Normal pressure hydrocephalus" not the answer?

Normal pressure hydrocephalus produces gait disturbance, urinary incontinence and dementia with enlarged ventricles.

What concept does this question test?

It tests Injuries and wounds: repeated head trauma in Forensic Medicine. Alzheimer disease features diffuse amyloid plaques and tangles. The history of boxing is the key.

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 Injuries and wounds: repeated head trauma?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic 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.