Systemic paediatrics: microcytic anaemia in thalassaemia trait: 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.

Try it

Pediatrics · Systemic paediatrics: microcytic anaemia in thalassaemia trait

Sample item

A 6-year-old has haemoglobin 9.4 g/dL, MCV 62 fL, RBC count 5.8 million per microlitre and a normal RDW. Ferritin is normal. Which diagnosis is most likely?

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

The answer and the reasoning

A. Beta thalassaemia trait

In thalassaemia trait the red cell count is high or normal for the degree of anaemia, cells are small and uniform, and the Mentzer index (MCV divided by RBC count) is below 13. Here it is about 10.7. In iron deficiency the RBC count is low, RDW is raised and the index exceeds 13. Haemoglobin electrophoresis shows raised HbA2.

Option by option

  • A. Beta thalassaemia trait (correct)

    Correct. A high RBC count, normal RDW and Mentzer index under 13 favour thalassaemia trait.

  • B. Sideroblastic anaemia

    Sideroblastic anaemia has a dimorphic picture and a raised ferritin and is uncommon in childhood.

  • C. Iron deficiency anaemia

    Iron deficiency gives a low RBC count, wide RDW and low ferritin.

  • D. Anaemia of chronic disease

    Chronic disease usually gives normocytic or mildly microcytic cells with a normal or high ferritin and a low RBC count.

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 A, Beta thalassaemia trait. In thalassaemia trait the red cell count is high or normal for the degree of anaemia, cells are small and uniform, and the Mentzer index (MCV divided by RBC count) is below 13.

Why is "Sideroblastic anaemia" not the answer?

Sideroblastic anaemia has a dimorphic picture and a raised ferritin and is uncommon in childhood.

Why is "Iron deficiency anaemia" not the answer?

Iron deficiency gives a low RBC count, wide RDW and low ferritin.

Why is "Anaemia of chronic disease" not the answer?

Chronic disease usually gives normocytic or mildly microcytic cells with a normal or high ferritin and a low RBC count.

What concept does this question test?

It tests Systemic paediatrics: microcytic anaemia in thalassaemia trait in Pediatrics. Here it is about 10.7. In iron deficiency the RBC count is low, RDW is raised and the index exceeds 13. Haemoglobin electrophoresis shows raised HbA2.

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: microcytic anaemia in thalassaemia trait?

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.