Neonatology: intraventricular haemorrhage: 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 · Neonatology: intraventricular haemorrhage

Sample item

A 28-week preterm becomes pale and hypotonic on day 2 with a bulging fontanelle and a falling haematocrit. Which investigation confirms the likely diagnosis, and where does the bleed begin?

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

The answer and the reasoning

A. Cranial ultrasound; germinal matrix

Intraventricular haemorrhage in preterm infants originates in the fragile subependymal germinal matrix and is graded by Papile on cranial ultrasound. It is most often seen in the first 72 hours.

Option by option

  • A. Cranial ultrasound; germinal matrix (correct)

    Correct. Cranial ultrasound at the bedside shows the bleed from the germinal matrix.

  • B. Lumbar puncture; subarachnoid space

    Lumbar puncture is not used to diagnose IVH and may be unsafe.

  • C. CT abdomen; adrenal gland

    Adrenal bleeding does not cause bulging fontanelle with hypotonia.

  • D. Chest X-ray; lung

    Chest X-ray does not show intracranial haemorrhage.

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 A, Cranial ultrasound; germinal matrix. Intraventricular haemorrhage in preterm infants originates in the fragile subependymal germinal matrix and is graded by Papile on cranial ultrasound.

Why is "Lumbar puncture; subarachnoid space" not the answer?

Lumbar puncture is not used to diagnose IVH and may be unsafe.

Why is "CT abdomen; adrenal gland" not the answer?

Adrenal bleeding does not cause bulging fontanelle with hypotonia.

Why is "Chest X-ray; lung" not the answer?

Chest X-ray does not show intracranial haemorrhage.

What concept does this question test?

It tests Neonatology: intraventricular haemorrhage in Pediatrics. It is most often seen in the first 72 hours.

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 Neonatology: intraventricular haemorrhage?

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.