Neonatal surgery: 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 · Neonatal surgery

Sample item

Which metabolic abnormality is typical of infantile hypertrophic pyloric stenosis?

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

The answer and the reasoning

A. Hypochloraemic, hypokalaemic metabolic alkalosis

Projectile non-bilious vomiting loses hydrochloric acid, producing hypochloraemic metabolic alkalosis, with potassium lost in urine. A palpable olive-shaped mass and visible peristalsis support the diagnosis. Rehydration and electrolyte correction precede pyloromyotomy.

Option by option

  • A. Hypochloraemic, hypokalaemic metabolic alkalosis (correct)

    Correct. Loss of gastric acid and chloride drives the alkalosis.

  • B. Hyperchloraemic metabolic acidosis

    Hyperchloraemic acidosis occurs in diarrhoea and renal tubular acidosis.

  • C. Hyperkalaemic metabolic acidosis

    Hyperkalaemic acidosis is seen in renal failure or adrenal insufficiency.

  • D. Respiratory alkalosis

    Respiratory alkalosis is a primary hyperventilation state.

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, Hypochloraemic, hypokalaemic metabolic alkalosis. Projectile non-bilious vomiting loses hydrochloric acid, producing hypochloraemic metabolic alkalosis, with potassium lost in urine.

Why is "Hyperchloraemic metabolic acidosis" not the answer?

Hyperchloraemic acidosis occurs in diarrhoea and renal tubular acidosis.

Why is "Hyperkalaemic metabolic acidosis" not the answer?

Hyperkalaemic acidosis is seen in renal failure or adrenal insufficiency.

Why is "Respiratory alkalosis" not the answer?

Respiratory alkalosis is a primary hyperventilation state.

What concept does this question test?

It tests Neonatal surgery in Pediatrics. A palpable olive-shaped mass and visible peristalsis support the diagnosis. Rehydration and electrolyte correction precede pyloromyotomy.

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 Neonatal surgery?

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.