Paediatric emergencies: acute liver failure in children: 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 · Paediatric emergencies: acute liver failure in children

Sample item

A 4-year-old with jaundice develops encephalopathy and INR of 3.0 not corrected by vitamin K. Which statement about the cause and management is correct?

AMetabolic causes and drugs such as paracetamol are important; N-acetylcysteine is used in suspected paracetamol toxicity and supportive care in othersBSteroids reverse all casesCTransplantation is never requiredDOnly viral causes occur; antivirals always cure

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

The answer and the reasoning

A. Metabolic causes and drugs such as paracetamol are important; N-acetylcysteine is used in suspected paracetamol toxicity and supportive care in others

Paediatric acute liver failure is defined by coagulopathy not corrected by vitamin K, with or without encephalopathy. Causes include viral hepatitis, metabolic disorders (Wilson disease, galactosaemia), and drugs such as paracetamol, and management is supportive, with transplantation in selected cases.

Option by option

A. Metabolic causes and drugs such as paracetamol are important; N-acetylcysteine is used in suspected paracetamol toxicity and supportive care in others (correct)
Correct. A broad cause list is considered and NAC is used for paracetamol.
B. Steroids reverse all cases
Steroids are not generally beneficial.
C. Transplantation is never required
Liver transplantation can be lifesaving.
D. Only viral causes occur; antivirals always cure
Many causes other than viruses exist.

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, Metabolic causes and drugs such as paracetamol are important; N-acetylcysteine is used in suspected paracetamol toxicity and supportive care in others. Paediatric acute liver failure is defined by coagulopathy not corrected by vitamin K, with or without encephalopathy.

Why is "Steroids reverse all cases" not the answer?

Steroids are not generally beneficial.

Why is "Transplantation is never required" not the answer?

Liver transplantation can be lifesaving.

Why is "Only viral causes occur; antivirals always cure" not the answer?

Many causes other than viruses exist.

What concept does this question test?

It tests Paediatric emergencies: acute liver failure in children in Pediatrics. Causes include viral hepatitis, metabolic disorders (Wilson disease, galactosaemia), and drugs such as paracetamol, and management is supportive, with transplantation in selected cases.

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 Paediatric emergencies: acute liver failure in children?

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.