Nutrition: iron deficiency: 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: iron deficiency

Sample item

A 14-month-old on exclusive milk feeds is pale with Hb 7 g/dl, microcytic hypochromic indices and a high red cell distribution width. Which parameter falls earliest in the development of iron deficiency?

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

The answer and the reasoning

C. Serum ferritin

Stages of iron deficiency start with depleted stores, so ferritin falls first, followed by a fall in serum iron and a rise in transferrin and TIBC, then microcytosis and anaemia. Ferritin is an acute-phase reactant and may be falsely normal in infection. Treatment is oral elemental iron 3 mg/kg/day for at least 3 months.

Option by option

  • A. Haemoglobin

    Haemoglobin falls late.

  • B. Serum transferrin

    Transferrin rises rather than falls.

  • C. Serum ferritin (correct)

    Correct. Ferritin falls first as stores deplete.

  • D. MCV

    MCV falls later, once erythropoiesis is iron-limited.

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 C, Serum ferritin. Stages of iron deficiency start with depleted stores, so ferritin falls first, followed by a fall in serum iron and a rise in transferrin and TIBC, then microcytosis and anaemia.

Why is "Haemoglobin" not the answer?

Haemoglobin falls late.

Why is "Serum transferrin" not the answer?

Transferrin rises rather than falls.

Why is "MCV" not the answer?

MCV falls later, once erythropoiesis is iron-limited.

What concept does this question test?

It tests Nutrition: iron deficiency in Pediatrics. Ferritin is an acute-phase reactant and may be falsely normal in infection. Treatment is oral elemental iron 3 mg/kg/day for at least 3 months.

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: iron deficiency?

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.