Neonatal jaundice: 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.

Try it

Pediatrics · Neonatal jaundice

Sample item

A 4-week-old breastfed infant has persistent jaundice, pale stools and dark urine. What is the most appropriate next step?

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

The answer and the reasoning

C. Measure total and conjugated bilirubin

Jaundice beyond two weeks with pale stools and dark urine suggests conjugated hyperbilirubinaemia. Biliary atresia is the key diagnosis to exclude, since early surgery improves outcome. The first step is fractionation of the bilirubin, followed by ultrasound and further evaluation.

Option by option

  • A. Reassure that this is breast-milk jaundice

    Breast-milk jaundice is unconjugated, and pale stools exclude it as an explanation.

  • B. Advise change to a lactose-free formula

    A formula change does not address cholestasis.

  • C. Measure total and conjugated bilirubin (correct)

    Correct. A conjugated fraction indicates cholestasis needing urgent evaluation.

  • D. Start phototherapy and review after a week

    Phototherapy treats unconjugated bilirubin and would delay the diagnosis.

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.

More Pediatrics questions

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is C, Measure total and conjugated bilirubin. Jaundice beyond two weeks with pale stools and dark urine suggests conjugated hyperbilirubinaemia.

Why is "Reassure that this is breast-milk jaundice" not the answer?

Breast-milk jaundice is unconjugated, and pale stools exclude it as an explanation.

Why is "Advise change to a lactose-free formula" not the answer?

A formula change does not address cholestasis.

Why is "Start phototherapy and review after a week" not the answer?

Phototherapy treats unconjugated bilirubin and would delay the diagnosis.

What concept does this question test?

It tests Neonatal jaundice in Pediatrics. Biliary atresia is the key diagnosis to exclude, since early surgery improves outcome. The first step is fractionation of the bilirubin, followed by ultrasound and further evaluation.

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 jaundice?

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.