Nutrition and malnutrition: therapeutic formulas for allergy: 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 and malnutrition: therapeutic formulas for allergy

Sample item

A 2-month-old fed on cow's milk formula has bloody stools, vomiting and eczema. Which formula is appropriate?

ASoy-based formula as universal first-lineBExtensively hydrolysed formulaCGoat milk formulaDStandard cow's milk formula

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

The answer and the reasoning

B. Extensively hydrolysed formula

Suspected cow's milk protein allergy needs a cow's milk-free diet, with extensively hydrolysed formula as first choice. Goat milk shows cross-reactivity and soy has cross-reaction in some infants.

Option by option

A. Soy-based formula as universal first-line
Soy is not a universal first-line option because of cross-reactivity.
B. Extensively hydrolysed formula (correct)
Correct. Extensively hydrolysed formula is recommended.
C. Goat milk formula
Goat milk proteins cross-react with cow's milk proteins.
D. Standard cow's milk formula
Standard formula contains the offending protein.

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 B, Extensively hydrolysed formula. Suspected cow's milk protein allergy needs a cow's milk-free diet, with extensively hydrolysed formula as first choice.

Why is "Soy-based formula as universal first-line" not the answer?

Soy is not a universal first-line option because of cross-reactivity.

Why is "Goat milk formula" not the answer?

Goat milk proteins cross-react with cow's milk proteins.

Why is "Standard cow's milk formula" not the answer?

Standard formula contains the offending protein.

What concept does this question test?

It tests Nutrition and malnutrition: therapeutic formulas for allergy in Pediatrics. Goat milk shows cross-reactivity and soy has cross-reaction in some infants.

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 and malnutrition: therapeutic formulas for allergy?

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.