Paediatric emergencies: neurotoxic snake bite: 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 · Paediatric emergencies: neurotoxic snake bite

Sample item

A 9-year-old who was sleeping on the floor wakes with severe abdominal pain, then develops ptosis and difficulty swallowing. There is no local swelling at a tiny bite mark. Which management is most appropriate?

AObservation, as the absence of local swelling excludes envenomingBFasciotomy to relieve compartment pressureCPolyvalent anti-snake venom with readiness for ventilationDHeparin to prevent consumption coagulopathy

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

The answer and the reasoning

C. Polyvalent anti-snake venom with readiness for ventilation

A bite during sleep with abdominal pain and progressive descending paralysis suggests a common krait, whose neurotoxic venom causes little local reaction. Polyvalent anti-snake venom should be given early, with airway support and mechanical ventilation as needed, and a trial of neostigmine may help. Waiting for local signs delays treatment.

Option by option

A. Observation, as the absence of local swelling excludes envenoming
Krait envenoming can be severe despite minimal local signs, so observation alone is unsafe.
B. Fasciotomy to relieve compartment pressure
Fasciotomy is for compartment syndrome in viper bites and is not indicated here.
C. Polyvalent anti-snake venom with readiness for ventilation (correct)
Correct. Early antivenom with ventilatory support is the mainstay for neurotoxic envenoming.
D. Heparin to prevent consumption coagulopathy
Heparin is not used and can worsen bleeding in snake bites.

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.

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is C, Polyvalent anti-snake venom with readiness for ventilation. A bite during sleep with abdominal pain and progressive descending paralysis suggests a common krait, whose neurotoxic venom causes little local reaction.

Why is "Observation, as the absence of local swelling excludes envenoming" not the answer?

Krait envenoming can be severe despite minimal local signs, so observation alone is unsafe.

Why is "Fasciotomy to relieve compartment pressure" not the answer?

Fasciotomy is for compartment syndrome in viper bites and is not indicated here.

Why is "Heparin to prevent consumption coagulopathy" not the answer?

Heparin is not used and can worsen bleeding in snake bites.

What concept does this question test?

It tests Paediatric emergencies: neurotoxic snake bite in Pediatrics. Polyvalent anti-snake venom should be given early, with airway support and mechanical ventilation as needed, and a trial of neostigmine may help. Waiting for local signs delays treatment.

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 Paediatric emergencies: neurotoxic snake bite?

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.