Neonatology: Rh haemolytic disease: 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: Rh haemolytic disease

Sample item

A baby of an Rh-negative mother with a previous unprotected pregnancy is born pale, oedematous and hepatosplenomegaly with a strongly positive Coombs test and cord bilirubin of 5 mg/dL. What is the most appropriate management?

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

The answer and the reasoning

C. Intensive phototherapy and early exchange transfusion, with correction of anaemia

Rh haemolytic disease with hydrops, severe anaemia and a high early bilirubin requires urgent exchange transfusion and intensive phototherapy. Exchange removes sensitised red cells, bilirubin and antibodies.

Option by option

  • A. Oral phenobarbitone

    Phenobarbitone has no role in the acute management of haemolysis.

  • B. Reassurance and discharge

    Discharge would be dangerous with hydrops and severe haemolysis.

  • C. Intensive phototherapy and early exchange transfusion, with correction of anaemia (correct)

    Correct. Severe Rh disease needs exchange transfusion.

  • D. Phototherapy alone

    Phototherapy alone cannot control the rapid rise in severe disease.

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 C, Intensive phototherapy and early exchange transfusion, with correction of anaemia. Rh haemolytic disease with hydrops, severe anaemia and a high early bilirubin requires urgent exchange transfusion and intensive phototherapy.

Why is "Oral phenobarbitone" not the answer?

Phenobarbitone has no role in the acute management of haemolysis.

Why is "Reassurance and discharge" not the answer?

Discharge would be dangerous with hydrops and severe haemolysis.

Why is "Phototherapy alone" not the answer?

Phototherapy alone cannot control the rapid rise in severe disease.

What concept does this question test?

It tests Neonatology: Rh haemolytic disease in Pediatrics. Exchange removes sensitised red cells, bilirubin and antibodies.

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 Neonatology: Rh haemolytic disease?

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.