Nutrition and malnutrition: ten steps of SAM management: 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: ten steps of SAM management

Sample item

In the WHO ten-step plan for a hospitalised child with severe acute malnutrition, which is the correct early order of priorities?

ATreat hypoglycaemia and hypothermia, correct dehydration cautiously, then electrolytes and infectionBStart catch-up growth feeds first and treat infection laterCGive iron on day 1DGive large IV fluid boluses first

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

The answer and the reasoning

A. Treat hypoglycaemia and hypothermia, correct dehydration cautiously, then electrolytes and infection

The first steps are treating or preventing hypoglycaemia, hypothermia and dehydration, followed by correcting electrolytes, treating infection, and correcting micronutrient deficiencies without iron initially. Catch-up feeding follows stabilisation.

Option by option

A. Treat hypoglycaemia and hypothermia, correct dehydration cautiously, then electrolytes and infection (correct)
Correct. This follows the WHO order.
B. Start catch-up growth feeds first and treat infection later
Catch-up feeds are for the rehabilitation phase.
C. Give iron on day 1
Iron is withheld until the child has stabilised and is eating well.
D. Give large IV fluid boluses first
Rapid IV fluids can cause heart failure in SAM.

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, Treat hypoglycaemia and hypothermia, correct dehydration cautiously, then electrolytes and infection. The first steps are treating or preventing hypoglycaemia, hypothermia and dehydration, followed by correcting electrolytes, treating infection, and correcting micronutrient deficiencies without iron initially.

Why is "Start catch-up growth feeds first and treat infection later" not the answer?

Catch-up feeds are for the rehabilitation phase.

Why is "Give iron on day 1" not the answer?

Iron is withheld until the child has stabilised and is eating well.

Why is "Give large IV fluid boluses first" not the answer?

Rapid IV fluids can cause heart failure in SAM.

What concept does this question test?

It tests Nutrition and malnutrition: ten steps of SAM management in Pediatrics. Catch-up feeding follows stabilisation.

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 Nutrition and malnutrition: ten steps of SAM management?

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.