Neurology: 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 · Neurology

Sample item

A 30-year-old man develops ascending leg weakness with absent knee jerks two weeks after a diarrhoeal illness. Sensation is nearly normal. What is the most important next step in his care?

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

The answer and the reasoning

B. Admit and monitor respiratory function with serial forced vital capacity

Acute ascending areflexic weakness after an infection suggests Guillain-Barre syndrome. Respiratory muscle failure and autonomic instability are the dangerous complications, so patients are admitted for serial vital capacity monitoring while IV immunoglobulin or plasma exchange is arranged.

Option by option

  • A. Start high-dose oral corticosteroids

    Corticosteroids have not been shown to help in Guillain-Barre syndrome.

  • B. Admit and monitor respiratory function with serial forced vital capacity (correct)

    Correct. Falling forced vital capacity predicts respiratory failure and the need for ventilation.

  • C. Discharge with outpatient physiotherapy

    Discharge is unsafe because weakness can progress rapidly to respiratory failure.

  • D. Start antibiotics for the diarrhoea and observe at home

    Antibiotics do not alter the immune-mediated neuropathy, and home observation misses deterioration.

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 General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Admit and monitor respiratory function with serial forced vital capacity. Acute ascending areflexic weakness after an infection suggests Guillain-Barre syndrome.

Why is "Start high-dose oral corticosteroids" not the answer?

Corticosteroids have not been shown to help in Guillain-Barre syndrome.

Why is "Discharge with outpatient physiotherapy" not the answer?

Discharge is unsafe because weakness can progress rapidly to respiratory failure.

Why is "Start antibiotics for the diarrhoea and observe at home" not the answer?

Antibiotics do not alter the immune-mediated neuropathy, and home observation misses deterioration.

What concept does this question test?

It tests Neurology in General Medicine. Respiratory muscle failure and autonomic instability are the dangerous complications, so patients are admitted for serial vital capacity monitoring while IV immunoglobulin or plasma exchange is arranged.

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 Neurology?

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.