Systemic paediatrics: acute myocarditis: 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: acute myocarditis

Sample item

A 5-year-old develops tachypnoea, tachycardia, a gallop rhythm and hepatomegaly a week after a viral URI. Chest radiograph shows cardiomegaly, ECG shows low voltages with ST-T changes, and troponin is raised. What is the commonest cause?

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

The answer and the reasoning

B. Coxsackie B virus infection

Viral infection, especially Coxsackie B and adenoviruses, is the commonest cause of acute myocarditis in children. It presents with heart failure, arrhythmias, ST-T changes and raised troponin. Management is supportive heart failure care and monitoring for arrhythmia.

Option by option

  • A. Group A streptococcal infection

    Streptococcal infection acts through rheumatic fever, which presents after weeks and with other major criteria.

  • B. Coxsackie B virus infection (correct)

    Correct. Coxsackie B and other viruses are the leading cause.

  • C. Trypanosoma cruzi infection

    Chagas disease is limited to endemic regions of the Americas.

  • D. Corynebacterium diphtheriae toxin

    Diphtheritic myocarditis is a rare complication of throat disease in unimmunised children.

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 Pediatrics questions

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is B, Coxsackie B virus infection. Viral infection, especially Coxsackie B and adenoviruses, is the commonest cause of acute myocarditis in children.

Why is "Group A streptococcal infection" not the answer?

Streptococcal infection acts through rheumatic fever, which presents after weeks and with other major criteria.

Why is "Trypanosoma cruzi infection" not the answer?

Chagas disease is limited to endemic regions of the Americas.

Why is "Corynebacterium diphtheriae toxin" not the answer?

Diphtheritic myocarditis is a rare complication of throat disease in unimmunised children.

What concept does this question test?

It tests Systemic paediatrics: acute myocarditis in Pediatrics. It presents with heart failure, arrhythmias, ST-T changes and raised troponin. Management is supportive heart failure care and monitoring for arrhythmia.

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: acute myocarditis?

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.