Neuroimaging: ADEM: 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.

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Radiology · Neuroimaging: ADEM

Sample item

A 7-year-old child develops encephalopathy and ataxia two weeks after a viral illness. MRI shows multiple large, asymmetric, poorly defined T2 hyperintense lesions in the subcortical white matter and thalami. What is the diagnosis?

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

The answer and the reasoning

A. Acute disseminated encephalomyelitis

ADEM is a monophasic post-infectious demyelinating disease with large, bilateral and asymmetric white matter and deep grey lesions. Unlike multiple sclerosis, it usually does not recur and lesions resolve with steroids.

Option by option

  • A. Acute disseminated encephalomyelitis (correct)

    Correct. A post-viral monophasic illness with large asymmetric lesions is ADEM.

  • B. Tuberous sclerosis

    Tuberous sclerosis shows tubers and subependymal nodules.

  • C. Herpes simplex encephalitis

    HSV encephalitis is confined mainly to the temporal lobes and insula.

  • D. Multiple sclerosis

    MS lesions are periventricular, ovoid and smaller, with relapses.

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, Acute disseminated encephalomyelitis. ADEM is a monophasic post-infectious demyelinating disease with large, bilateral and asymmetric white matter and deep grey lesions.

Why is "Tuberous sclerosis" not the answer?

Tuberous sclerosis shows tubers and subependymal nodules.

Why is "Herpes simplex encephalitis" not the answer?

HSV encephalitis is confined mainly to the temporal lobes and insula.

Why is "Multiple sclerosis" not the answer?

MS lesions are periventricular, ovoid and smaller, with relapses.

What concept does this question test?

It tests Neuroimaging: ADEM in Radiology. Unlike multiple sclerosis, it usually does not recur and lesions resolve with steroids.

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: ADEM?

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.