Bone and joint infections: skeletal tuberculosis: practice question

A Orthopaedics 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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Orthopaedics · Bone and joint infections: skeletal tuberculosis

Sample item

A 30-year-old has weight loss, a dorsal spine tuberculous lesion with a paravertebral abscess and early paraparesis, and the spine is stable. What is the initial treatment?

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

The answer and the reasoning

A. Antitubercular drugs with rest and neurological monitoring

Early paraparesis in active spinal tuberculosis often responds to multidrug antitubercular therapy. Surgery is added if there is no neurological improvement after a few weeks, or instability, or deterioration.

Option by option

  • A. Antitubercular drugs with rest and neurological monitoring (correct)

    Correct. Drug therapy with monitoring is the first step in a stable spine with early deficit.

  • B. Immediate posterior laminectomy

    Laminectomy removes posterior elements and causes instability without addressing anterior disease.

  • C. Anterior radical debridement before starting drugs

    Surgery before any drug cover is not the first step in a stable, improving lesion.

  • D. Observation without drugs for six weeks

    Withholding drugs allows progression to severe paraplegia.

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 Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is A, Antitubercular drugs with rest and neurological monitoring. Early paraparesis in active spinal tuberculosis often responds to multidrug antitubercular therapy.

Why is "Immediate posterior laminectomy" not the answer?

Laminectomy removes posterior elements and causes instability without addressing anterior disease.

Why is "Anterior radical debridement before starting drugs" not the answer?

Surgery before any drug cover is not the first step in a stable, improving lesion.

Why is "Observation without drugs for six weeks" not the answer?

Withholding drugs allows progression to severe paraplegia.

What concept does this question test?

It tests Bone and joint infections: skeletal tuberculosis in Orthopaedics. Surgery is added if there is no neurological improvement after a few weeks, or instability, or deterioration.

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 Bone and joint infections: skeletal tuberculosis?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics 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.