Nutrition and malnutrition: rickets biochemistry and imaging: 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: rickets biochemistry and imaging

Sample item

In active nutritional rickets, which biochemical pattern and radiographic finding are expected?

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

The answer and the reasoning

B. Low phosphate, raised alkaline phosphatase and PTH; cupping and fraying of metaphyses

In vitamin D deficiency rickets calcium is low or normal, phosphate is low, ALP and PTH are raised. Wrist X-ray shows widening, cupping and fraying of the metaphyses.

Option by option

  • A. Raised calcium, raised phosphate; bone-in-bone appearance

    A bone-in-bone appearance is typical of osteopetrosis.

  • B. Low phosphate, raised alkaline phosphatase and PTH; cupping and fraying of metaphyses (correct)

    Correct. This matches the biochemistry and imaging.

  • C. Raised phosphate, low ALP; metaphyseal sclerosis

    Phosphate is low rather than raised in active rickets.

  • D. Normal ALP and PTH; osteopenia only

    ALP is typically markedly raised.

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 B, Low phosphate, raised alkaline phosphatase and PTH; cupping and fraying of metaphyses. In vitamin D deficiency rickets calcium is low or normal, phosphate is low, ALP and PTH are raised.

Why is "Raised calcium, raised phosphate; bone-in-bone appearance" not the answer?

A bone-in-bone appearance is typical of osteopetrosis.

Why is "Raised phosphate, low ALP; metaphyseal sclerosis" not the answer?

Phosphate is low rather than raised in active rickets.

Why is "Normal ALP and PTH; osteopenia only" not the answer?

ALP is typically markedly raised.

What concept does this question test?

It tests Nutrition and malnutrition: rickets biochemistry and imaging in Pediatrics. Wrist X-ray shows widening, cupping and fraying of the metaphyses.

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: rickets biochemistry and imaging?

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.