Infectious diseases: recognition: 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 · Infectious diseases: recognition

Sample item

A patient with HIV and CD4 count of 40 per microlitre has headache, fever and hemiparesis. CT shows multiple ring-enhancing lesions in the basal ganglia and serology shows prior IgG exposure to the protozoan. What is the diagnosis?

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

The answer and the reasoning

C. Cerebral toxoplasmosis

Reactivation of latent protozoal infection causes multiple ring-enhancing basal ganglia lesions in advanced HIV. Empirical pyrimethamine-sulfadiazine is given and response confirms the diagnosis. Lymphoma is usually a single periventricular lesion.

Option by option

  • A. Tuberculoma

    Tuberculoma suggests tuberculous exposure or meningitis.

  • B. Primary CNS lymphoma

    Lymphoma is typically solitary and periventricular.

  • C. Cerebral toxoplasmosis (correct)

    Correct. Multiple basal ganglia ring lesions with low CD4 and IgG fit.

  • D. Neurocysticercosis

    Neurocysticercosis shows cysts with a scolex in endemic regions.

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 Medicine question

What is the answer to this General Medicine question?

The best answer is C, Cerebral toxoplasmosis. Reactivation of latent protozoal infection causes multiple ring-enhancing basal ganglia lesions in advanced HIV.

Why is "Tuberculoma" not the answer?

Tuberculoma suggests tuberculous exposure or meningitis.

Why is "Primary CNS lymphoma" not the answer?

Lymphoma is typically solitary and periventricular.

Why is "Neurocysticercosis" not the answer?

Neurocysticercosis shows cysts with a scolex in endemic regions.

What concept does this question test?

It tests Infectious diseases: recognition in General Medicine. Empirical pyrimethamine-sulfadiazine is given and response confirms the diagnosis. Lymphoma is usually a single periventricular lesion.

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 Infectious diseases: recognition?

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.