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MRCP Part 2 Written Question of the Day

Try our Question of the Day based on topics that appeared in the November 2011 exam.

A 72-year-old man presents to hospital with a three month history of increasing confusion, urinary incontinence and falls.

A confusion screen is performed. Bloods are normal except for low B12 levels. CT brain shows enlarged ventricles. Lumbar puncture is performed and CSF opening pressure is 15 cmH2O with normal CSF. 30 mls of CSF are removed with some improvement in the patient's symptoms.

What is the next step in treating this gentleman?

(Please select 1 option)

B12 replacement
CSF drainage with repeated lumbar punctures
External ventricular drain
MRI brain
Ventriculo-peritoneal shunt

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