Systemic paediatrics: thalassaemia major transfusion: 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 · Systemic paediatrics: thalassaemia major transfusion

Sample item

A 2-year-old with transfusion-dependent beta thalassaemia major is started on regular transfusions. What pre-transfusion haemoglobin target and curative option apply?

A11 to 12 g/dL; folic acid aloneB6 to 7 g/dL; splenectomyC9.5 to 10.5 g/dL; haematopoietic stem cell transplantationD13 to 14 g/dL; iron supplements

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

The answer and the reasoning

C. 9.5 to 10.5 g/dL; haematopoietic stem cell transplantation

Transfusion regimens maintain a pre-transfusion haemoglobin of 9.5 to 10.5 g/dL to suppress ineffective erythropoiesis, with iron chelation to prevent overload. Allogeneic stem cell transplantation is the only established cure.

Option by option

A. 11 to 12 g/dL; folic acid alone
Folic acid alone is inadequate.
B. 6 to 7 g/dL; splenectomy
Under-transfusion leads to bone deformities and iron absorption.
C. 9.5 to 10.5 g/dL; haematopoietic stem cell transplantation (correct)
Correct. This is the standard target and cure.
D. 13 to 14 g/dL; iron supplements
Iron supplements are contraindicated.

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 C, 9.5 to 10.5 g/dL; haematopoietic stem cell transplantation. Transfusion regimens maintain a pre-transfusion haemoglobin of 9.

Why is "11 to 12 g/dL; folic acid alone" not the answer?

Folic acid alone is inadequate.

Why is "6 to 7 g/dL; splenectomy" not the answer?

Under-transfusion leads to bone deformities and iron absorption.

Why is "13 to 14 g/dL; iron supplements" not the answer?

Iron supplements are contraindicated.

What concept does this question test?

It tests Systemic paediatrics: thalassaemia major transfusion in Pediatrics. 5 to 10.5 g/dL to suppress ineffective erythropoiesis, with iron chelation to prevent overload. Allogeneic stem cell transplantation is the only established cure.

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 Systemic paediatrics: thalassaemia major transfusion?

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.