Neonatology: symmetric vs asymmetric IUGR: 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 · Neonatology: symmetric vs asymmetric IUGR

Sample item

A newborn has weight, length and head circumference all below the 10th centile. Which insult most likely explains this pattern?

AAn early gestational insult such as a congenital infection or chromosomal disorderBPost-term deliveryCLate pregnancy placental insufficiencyDMaternal diabetes

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

The answer and the reasoning

A. An early gestational insult such as a congenital infection or chromosomal disorder

Symmetric growth restriction reflects an early insult such as TORCH infection or chromosomal anomaly that reduces cell number. Asymmetric IUGR results from late placental insufficiency, with head sparing.

Option by option

A. An early gestational insult such as a congenital infection or chromosomal disorder (correct)
Correct. Symmetric IUGR indicates an early insult.
B. Post-term delivery
Post-term infants lose subcutaneous fat but not uniformly smaller.
C. Late pregnancy placental insufficiency
Late placental insufficiency leads to asymmetric restriction with head sparing.
D. Maternal diabetes
Maternal diabetes tends to cause macrosomia.

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, An early gestational insult such as a congenital infection or chromosomal disorder. Symmetric growth restriction reflects an early insult such as TORCH infection or chromosomal anomaly that reduces cell number.

Why is "Post-term delivery" not the answer?

Post-term infants lose subcutaneous fat but not uniformly smaller.

Why is "Late pregnancy placental insufficiency" not the answer?

Late placental insufficiency leads to asymmetric restriction with head sparing.

Why is "Maternal diabetes" not the answer?

Maternal diabetes tends to cause macrosomia.

What concept does this question test?

It tests Neonatology: symmetric vs asymmetric IUGR in Pediatrics. Asymmetric IUGR results from late placental insufficiency, with head sparing.

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 Neonatology: symmetric vs asymmetric IUGR?

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.