Neonatology: anaemia of prematurity: 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: anaemia of prematurity

Sample item

A 6-week-old born at 26 weeks is pale, feeds poorly and has tachycardia. Haemoglobin is 7.5 g/dL, with a low reticulocyte count and a negative Coombs test. What is the main mechanism?

AInadequate erythropoietin response with a short red cell lifespanBIron deficiency from exhausted maternal storesCOngoing alloimmune haemolysis from maternal antibodiesDPure red cell aplasia from a ribosomal gene defect

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

The answer and the reasoning

A. Inadequate erythropoietin response with a short red cell lifespan

Anaemia of prematurity is a physiological nadir exaggerated in preterm babies by low erythropoietin from the liver-based response, rapid growth, blood sampling and short red cell survival. Treatment includes transfusion when symptomatic, with iron supplementation later.

Option by option

A. Inadequate erythropoietin response with a short red cell lifespan (correct)
Correct. A blunted erythropoietin response and short red cell survival produce the early nadir.
B. Iron deficiency from exhausted maternal stores
Iron deficiency develops later, once stores are used up, rather than at 6 weeks.
C. Ongoing alloimmune haemolysis from maternal antibodies
A negative Coombs test excludes ongoing alloimmune haemolysis.
D. Pure red cell aplasia from a ribosomal gene defect
Diamond-Blackfan anaemia is rare and presents with macrocytic anaemia near birth, not as a typical nadir.

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 A, Inadequate erythropoietin response with a short red cell lifespan. Anaemia of prematurity is a physiological nadir exaggerated in preterm babies by low erythropoietin from the liver-based response, rapid growth, blood sampling and short red cell survival.

Why is "Iron deficiency from exhausted maternal stores" not the answer?

Iron deficiency develops later, once stores are used up, rather than at 6 weeks.

Why is "Ongoing alloimmune haemolysis from maternal antibodies" not the answer?

A negative Coombs test excludes ongoing alloimmune haemolysis.

Why is "Pure red cell aplasia from a ribosomal gene defect" not the answer?

Diamond-Blackfan anaemia is rare and presents with macrocytic anaemia near birth, not as a typical nadir.

What concept does this question test?

It tests Neonatology: anaemia of prematurity in Pediatrics. Treatment includes transfusion when symptomatic, with iron supplementation later.

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: anaemia of prematurity?

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.