Nutrition and malnutrition: hypocalcaemic seizure in rickets: 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 · Nutrition and malnutrition: hypocalcaemic seizure in rickets

Sample item

A 4-month-old with florid rickets has a generalised seizure. Serum calcium is 6.2 mg/dL. What is the immediate treatment?

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

The answer and the reasoning

D. Slow intravenous calcium gluconate with ECG monitoring

Seizures in rickets are caused by hypocalcaemia and respond to intravenous calcium gluconate given slowly under ECG monitoring. Vitamin D and oral calcium follow, but they act too slowly to stop the seizure.

Option by option

  • A. Oral vitamin D stat dose alone

    Vitamin D acts over days and does not treat the acute fit.

  • B. Intravenous magnesium sulphate

    Magnesium is not the cause and does not raise calcium acutely.

  • C. Phenytoin loading dose

    Anticonvulsants do not work well when the cause is low calcium.

  • D. Slow intravenous calcium gluconate with ECG monitoring (correct)

    Correct. Intravenous calcium corrects the cause and stops the fit.

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 D, Slow intravenous calcium gluconate with ECG monitoring. Seizures in rickets are caused by hypocalcaemia and respond to intravenous calcium gluconate given slowly under ECG monitoring.

Why is "Oral vitamin D stat dose alone" not the answer?

Vitamin D acts over days and does not treat the acute fit.

Why is "Intravenous magnesium sulphate" not the answer?

Magnesium is not the cause and does not raise calcium acutely.

Why is "Phenytoin loading dose" not the answer?

Anticonvulsants do not work well when the cause is low calcium.

What concept does this question test?

It tests Nutrition and malnutrition: hypocalcaemic seizure in rickets in Pediatrics. Vitamin D and oral calcium follow, but they act too slowly to stop the seizure.

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 Nutrition and malnutrition: hypocalcaemic seizure in rickets?

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.