Neuroimaging: hepatic encephalopathy: practice question

A Radiology 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.

Try it

Radiology · Neuroimaging: hepatic encephalopathy

Sample item

A patient with decompensated cirrhosis has MRI showing symmetric T1-hyperintense signal in both globi pallidi. CT shows no calcification and T2 images are normal. Which substance accounts for the signal?

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

The answer and the reasoning

A. Manganese

In chronic liver disease, shunting allows manganese to bypass hepatic clearance and deposit in the globi pallidi, where its paramagnetism shortens T1. Iron would be dark on T2, copper in Wilson disease causes T2 change, and calcification would be dense on CT.

Option by option

  • A. Manganese (correct)

    Correct. Manganese deposition shortens T1 in the pallidi.

  • B. Iron

    Iron deposition appears dark on T2-weighted images.

  • C. Copper

    Copper deposition in Wilson disease causes T2 abnormality and a different distribution.

  • D. Calcium

    Calcification would be hyperdense on CT, which is normal here.

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 Radiology questions

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is A, Manganese. In chronic liver disease, shunting allows manganese to bypass hepatic clearance and deposit in the globi pallidi, where its paramagnetism shortens T1.

Why is "Iron" not the answer?

Iron deposition appears dark on T2-weighted images.

Why is "Copper" not the answer?

Copper deposition in Wilson disease causes T2 abnormality and a different distribution.

Why is "Calcium" not the answer?

Calcification would be hyperdense on CT, which is normal here.

What concept does this question test?

It tests Neuroimaging: hepatic encephalopathy in Radiology. Iron would be dark on T2, copper in Wilson disease causes T2 change, and calcification would be dense on CT.

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 Neuroimaging: hepatic encephalopathy?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology 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.