Systemic paediatrics: sickle cell disease in infancy: 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: sickle cell disease in infancy

Sample item

A 9-month-old with HbSS presents with painful swelling of both hands and feet. What is the diagnosis, and what measure reduces the risk of fatal infection in these children?

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

The answer and the reasoning

B. Dactylitis; penicillin prophylaxis and pneumococcal vaccination

Dactylitis (hand-foot syndrome) is often the first vaso-occlusive manifestation of sickle cell disease. Functional asplenia predisposes to pneumococcal sepsis, so penicillin prophylaxis and pneumococcal vaccination are essential, with hydroxyurea for severe disease.

Option by option

  • A. Cellulitis; oral steroids

    Cellulitis is unilateral with fever and erythema.

  • B. Dactylitis; penicillin prophylaxis and pneumococcal vaccination (correct)

    Correct. This pairs the presentation with prevention.

  • C. Rickets; vitamin D

    Rickets presents with bony deformity rather than painful swelling.

  • D. Rheumatoid arthritis; methotrexate

    Rheumatoid arthritis does not cause bilateral dactylitis in infancy.

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, Dactylitis; penicillin prophylaxis and pneumococcal vaccination. Dactylitis (hand-foot syndrome) is often the first vaso-occlusive manifestation of sickle cell disease.

Why is "Cellulitis; oral steroids" not the answer?

Cellulitis is unilateral with fever and erythema.

Why is "Rickets; vitamin D" not the answer?

Rickets presents with bony deformity rather than painful swelling.

Why is "Rheumatoid arthritis; methotrexate" not the answer?

Rheumatoid arthritis does not cause bilateral dactylitis in infancy.

What concept does this question test?

It tests Systemic paediatrics: sickle cell disease in infancy in Pediatrics. Functional asplenia predisposes to pneumococcal sepsis, so penicillin prophylaxis and pneumococcal vaccination are essential, with hydroxyurea for severe disease.

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: sickle cell disease in infancy?

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.