Paediatric oncology: 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 · Paediatric oncology

Sample item

A 2-year-old has an abdominal mass that crosses the midline, periorbital ecchymoses, bone pain and raised urinary vanillylmandelic and homovanillic acid. What is the most likely diagnosis?

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

The answer and the reasoning

B. Neuroblastoma

Neuroblastoma arises from neural crest cells of the adrenal medulla or sympathetic chain. A firm mass that may cross the midline, orbital metastases causing raccoon eyes and raised urinary catecholamine metabolites are typical. Wilms tumour is smooth, usually does not cross the midline and does not raise catecholamines.

Option by option

  • A. Acute lymphoblastic leukaemia

    Leukaemia causes cytopenias and marrow failure and does not produce a mass with raised catecholamine metabolites.

  • B. Neuroblastoma (correct)

    Correct. The catecholamine metabolites and periorbital metastases are characteristic.

  • C. Hepatoblastoma

    Hepatoblastoma arises in the liver and raises alpha-fetoprotein, not catecholamine metabolites.

  • D. Wilms tumour

    Wilms tumour is a renal mass that seldom crosses the midline, with normal catecholamine metabolites.

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 B, Neuroblastoma. Neuroblastoma arises from neural crest cells of the adrenal medulla or sympathetic chain.

Why is "Acute lymphoblastic leukaemia" not the answer?

Leukaemia causes cytopenias and marrow failure and does not produce a mass with raised catecholamine metabolites.

Why is "Hepatoblastoma" not the answer?

Hepatoblastoma arises in the liver and raises alpha-fetoprotein, not catecholamine metabolites.

Why is "Wilms tumour" not the answer?

Wilms tumour is a renal mass that seldom crosses the midline, with normal catecholamine metabolites.

What concept does this question test?

It tests Paediatric oncology in Pediatrics. A firm mass that may cross the midline, orbital metastases causing raccoon eyes and raised urinary catecholamine metabolites are typical. Wilms tumour is smooth, usually does not cross the midline and does not raise catecholamines.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Paediatric oncology?

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.