Nutrition: referral of complicated SAM: practice question

A PSM 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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PSM · Nutrition: referral of complicated SAM

Sample item

A 14-month-old child has MUAC of 11 cm, fever, poor appetite and fast breathing. The appropriate management is:

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

The answer and the reasoning

D. Referral for inpatient care at a Nutrition Rehabilitation Centre

SAM with medical complications or poor appetite should be admitted for facility-based care. Uncomplicated SAM with good appetite can be managed at community level with RUTF and follow-up.

Option by option

  • A. Supplementary feeding at anganwadi only

    Anganwadi supplementation is inadequate for complicated SAM.

  • B. Give iron supplements and review in a month

    Iron and delayed review is unsafe with acute illness.

  • C. Community management with RUTF at home

    Home RUTF is for uncomplicated SAM with appetite.

  • D. Referral for inpatient care at a Nutrition Rehabilitation Centre (correct)

    Correct. Complicated SAM needs inpatient care.

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 PSM question

What is the answer to this PSM question?

The best answer is D, Referral for inpatient care at a Nutrition Rehabilitation Centre. SAM with medical complications or poor appetite should be admitted for facility-based care.

Why is "Supplementary feeding at anganwadi only" not the answer?

Anganwadi supplementation is inadequate for complicated SAM.

Why is "Give iron supplements and review in a month" not the answer?

Iron and delayed review is unsafe with acute illness.

Why is "Community management with RUTF at home" not the answer?

Home RUTF is for uncomplicated SAM with appetite.

What concept does this question test?

It tests Nutrition: referral of complicated SAM in PSM. Uncomplicated SAM with good appetite can be managed at community level with RUTF and follow-up.

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: referral of complicated SAM?

Practise biostatistics with small calculations until sensitivity, predictive values and risk measures are automatic. Then use the flashcards and the other PSM 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.