Neonatology: 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 · Neonatology

Sample item

A 30-week preterm infant on enteral feeds on day 8 develops abdominal distension, bilious aspirates and bloody stools. Abdominal radiograph shows linear intramural gas. What is the initial management?

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

The answer and the reasoning

C. Stop feeds, start broad-spectrum antibiotics, and decompress the stomach

Necrotising enterocolitis is an inflammatory bowel necrosis in preterm infants, and pneumatosis intestinalis is characteristic. Medical management consists of bowel rest, nasogastric decompression, intravenous fluids and antibiotics. Surgery is for perforation (free air), gangrene or clinical deterioration.

Option by option

  • A. Increase the volume of enteral feeds

    Increasing feeds would worsen the intestinal injury.

  • B. Give oral probiotics only

    Probiotics may help to prevent but do not treat established disease.

  • C. Stop feeds, start broad-spectrum antibiotics, and decompress the stomach (correct)

    Correct. Bowel rest with antibiotics is the first step in the absence of perforation.

  • D. Immediate laparotomy for all cases

    Surgery is reserved for perforation or failure of medical treatment.

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 C, Stop feeds, start broad-spectrum antibiotics, and decompress the stomach. Necrotising enterocolitis is an inflammatory bowel necrosis in preterm infants, and pneumatosis intestinalis is characteristic.

Why is "Increase the volume of enteral feeds" not the answer?

Increasing feeds would worsen the intestinal injury.

Why is "Give oral probiotics only" not the answer?

Probiotics may help to prevent but do not treat established disease.

Why is "Immediate laparotomy for all cases" not the answer?

Surgery is reserved for perforation or failure of medical treatment.

What concept does this question test?

It tests Neonatology in Pediatrics. Medical management consists of bowel rest, nasogastric decompression, intravenous fluids and antibiotics. Surgery is for perforation (free air), gangrene or clinical deterioration.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Neonatology?

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.