Nutrition: 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

Sample item

A 14-month-old exclusively breastfed child, rarely exposed to sunlight, has delayed walking, widened wrists, a rachitic rosary and Harrison sulcus. Alkaline phosphatase is raised. What is the first-line treatment?

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

The answer and the reasoning

A. Vitamin D with calcium supplementation

The features are those of nutritional rickets from vitamin D deficiency with inadequate sun exposure. Treatment is vitamin D with adequate calcium, and healing is monitored by falling alkaline phosphatase and radiological improvement.

Option by option

  • A. Vitamin D with calcium supplementation (correct)

    Correct. Replacing vitamin D with adequate calcium corrects nutritional rickets.

  • B. Oral iron

    Iron treats anaemia, which does not explain the bone changes.

  • C. Oral phosphate supplements alone

    Phosphate alone is used in hypophosphataemic rickets, not vitamin D deficiency.

  • D. Parathyroid hormone

    Parathyroid hormone raises calcium by bone resorption and is not a treatment for rickets.

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, Vitamin D with calcium supplementation. The features are those of nutritional rickets from vitamin D deficiency with inadequate sun exposure.

Why is "Oral iron" not the answer?

Iron treats anaemia, which does not explain the bone changes.

Why is "Oral phosphate supplements alone" not the answer?

Phosphate alone is used in hypophosphataemic rickets, not vitamin D deficiency.

Why is "Parathyroid hormone" not the answer?

Parathyroid hormone raises calcium by bone resorption and is not a treatment for rickets.

What concept does this question test?

It tests Nutrition in Pediatrics. Treatment is vitamin D with adequate calcium, and healing is monitored by falling alkaline phosphatase and radiological improvement.

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?

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.