Neonatology: polycythaemia: 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: polycythaemia

Sample item

A plethoric newborn has a venous haematocrit of 72 percent and is symptomatic with irritability and poor feeding. What is the treatment?

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

The answer and the reasoning

A. Partial exchange transfusion with normal saline

Neonatal polycythaemia is a venous haematocrit above 65 percent, and symptomatic cases need partial exchange transfusion with saline to lower viscosity. Complications are hypoglycaemia, jaundice, NEC and renal vein thrombosis. Risk factors include IDM, twin-twin transfusion and delayed cord clamping.

Option by option

  • A. Partial exchange transfusion with normal saline (correct)

    Correct. Partial exchange with saline reduces haematocrit.

  • B. Oral iron

    Iron would increase red cell production.

  • C. Phototherapy alone

    Phototherapy does not treat hyperviscosity.

  • D. Simple transfusion of packed cells

    Transfusing more red cells would worsen it.

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 A, Partial exchange transfusion with normal saline. Neonatal polycythaemia is a venous haematocrit above 65 percent, and symptomatic cases need partial exchange transfusion with saline to lower viscosity.

Why is "Oral iron" not the answer?

Iron would increase red cell production.

Why is "Phototherapy alone" not the answer?

Phototherapy does not treat hyperviscosity.

Why is "Simple transfusion of packed cells" not the answer?

Transfusing more red cells would worsen it.

What concept does this question test?

It tests Neonatology: polycythaemia in Pediatrics. Complications are hypoglycaemia, jaundice, NEC and renal vein thrombosis. Risk factors include IDM, twin-twin transfusion and delayed cord clamping.

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: polycythaemia?

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.