Malnutrition: hypoglycaemia: 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 · Malnutrition: hypoglycaemia

Sample item

A 14-month-old child with SAM is lethargic with blood glucose of 40 mg/dl. What should be done?

AGive 10 percent glucose 5 ml/kg IV, or oral or NG sugar solution if awake and able to drinkBWarm the child and waitCGive insulinDWithhold feeds and observe

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

The answer and the reasoning

A. Give 10 percent glucose 5 ml/kg IV, or oral or NG sugar solution if awake and able to drink

Hypoglycaemia in SAM is glucose below 54 mg/dl (3 mmol/L). It is treated with a glucose bolus, then frequent feeds every 2 hours, with antibiotics. Hypoglycaemia and hypothermia often occur together in malnourished children.

Option by option

A. Give 10 percent glucose 5 ml/kg IV, or oral or NG sugar solution if awake and able to drink (correct)
Correct. Prompt glucose with frequent feeds corrects hypoglycaemia.
B. Warm the child and wait
Warming alone does not treat low glucose.
C. Give insulin
Insulin would worsen hypoglycaemia.
D. Withhold feeds and observe
Observation can cause convulsions and death.

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, Give 10 percent glucose 5 ml/kg IV, or oral or NG sugar solution if awake and able to drink. Hypoglycaemia in SAM is glucose below 54 mg/dl (3 mmol/L).

Why is "Warm the child and wait" not the answer?

Warming alone does not treat low glucose.

Why is "Give insulin" not the answer?

Insulin would worsen hypoglycaemia.

Why is "Withhold feeds and observe" not the answer?

Observation can cause convulsions and death.

What concept does this question test?

It tests Malnutrition: hypoglycaemia in Pediatrics. It is treated with a glucose bolus, then frequent feeds every 2 hours, with antibiotics. Hypoglycaemia and hypothermia often occur together in malnourished children.

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 Malnutrition: hypoglycaemia?

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.