Paediatric infections: late complication of diphtheria: 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 infections: late complication of diphtheria

Sample item

A child recovering from pharyngeal diphtheria develops pallor, a rapid irregular pulse, a gallop rhythm and ECG evidence of heart block 2 weeks after onset. What is the likely cause?

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

The answer and the reasoning

D. Toxin-induced myocarditis

Diphtheria toxin damages myocardial fibres and the conduction system, and myocarditis in the second to third week is a leading cause of death. Peripheral neuropathy, including palatal palsy, can also occur. Early antitoxin reduces the risk.

Option by option

  • A. Viral pericarditis

    Viral pericarditis causes chest pain and a friction rub rather than heart block.

  • B. Infective endocarditis

    Endocarditis would cause persistent fever and embolic phenomena.

  • C. Acute rheumatic carditis

    Rheumatic carditis follows group A streptococcal infection, not diphtheria.

  • D. Toxin-induced myocarditis (correct)

    Correct. Toxin-mediated myocarditis with conduction block is the classic late complication.

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, Toxin-induced myocarditis. Diphtheria toxin damages myocardial fibres and the conduction system, and myocarditis in the second to third week is a leading cause of death.

Why is "Viral pericarditis" not the answer?

Viral pericarditis causes chest pain and a friction rub rather than heart block.

Why is "Infective endocarditis" not the answer?

Endocarditis would cause persistent fever and embolic phenomena.

Why is "Acute rheumatic carditis" not the answer?

Rheumatic carditis follows group A streptococcal infection, not diphtheria.

What concept does this question test?

It tests Paediatric infections: late complication of diphtheria in Pediatrics. Peripheral neuropathy, including palatal palsy, can also occur. Early antitoxin reduces the risk.

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 infections: late complication of diphtheria?

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.