Systemic paediatrics: idiopathic intracranial hypertension: practice question

A Pediatrics 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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Pediatrics · Systemic paediatrics: idiopathic intracranial hypertension

Sample item

An obese 13-year-old girl has headaches worse lying down, transient visual obscurations and pulsatile tinnitus. She has bilateral papilloedema, MRI shows no mass, and lumbar puncture shows a markedly raised opening pressure with normal CSF composition. Which is the first-line drug?

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

The answer and the reasoning

B. Acetazolamide

Idiopathic intracranial hypertension has raised CSF pressure with papilloedema, no mass, and normal CSF composition, and is linked to obesity. Acetazolamide reduces CSF production and is first-line, with weight loss, and surgery or optic nerve sheath fenestration when vision is threatened. Visual fields must be monitored.

Option by option

  • A. Mannitol

    Mannitol is used for acute raised pressure from mass lesions, not long-term treatment.

  • B. Acetazolamide (correct)

    Correct. Acetazolamide lowers CSF production and is the standard first drug.

  • C. Dexamethasone

    Dexamethasone does not help and can worsen weight gain.

  • D. Sumatriptan

    Sumatriptan treats migraine and does not lower intracranial pressure.

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 Pediatrics question

What is the answer to this Pediatrics question?

The best answer is B, Acetazolamide. Idiopathic intracranial hypertension has raised CSF pressure with papilloedema, no mass, and normal CSF composition, and is linked to obesity.

Why is "Mannitol" not the answer?

Mannitol is used for acute raised pressure from mass lesions, not long-term treatment.

Why is "Dexamethasone" not the answer?

Dexamethasone does not help and can worsen weight gain.

Why is "Sumatriptan" not the answer?

Sumatriptan treats migraine and does not lower intracranial pressure.

What concept does this question test?

It tests Systemic paediatrics: idiopathic intracranial hypertension in Pediatrics. Acetazolamide reduces CSF production and is first-line, with weight loss, and surgery or optic nerve sheath fenestration when vision is threatened. Visual fields must be monitored.

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 Systemic paediatrics: idiopathic intracranial hypertension?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.