Rheumatology: neonatal lupus: practice question

A General Medicine 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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General Medicine · Rheumatology: neonatal lupus

Sample item

A newborn has a heart rate of 55 per minute and an ECG showing complete heart block. The mother is asymptomatic, and later tests suggest Sjogren syndrome. Which maternal antibody is responsible?

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

The answer and the reasoning

D. Anti-Ro (SSA)

Maternal IgG anti-Ro (SSA), and sometimes anti-La, crosses the placenta from about 16 to 24 weeks and injures the fetal conduction system, causing congenital heart block. The mother may be asymptomatic. Neonatal lupus may also cause a transient rash, cytopenias and hepatic involvement.

Option by option

  • A. Anti-Smith

    Anti-Smith is specific for SLE but is not linked to neonatal heart block.

  • B. Anti-double-stranded DNA

    Anti-dsDNA relates to lupus nephritis and does not cause congenital block.

  • C. Anti-centromere

    Anti-centromere is associated with limited systemic sclerosis.

  • D. Anti-Ro (SSA) (correct)

    Correct. Transplacental anti-Ro causes immune damage to the fetal atrioventricular node.

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 General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Anti-Ro (SSA). Maternal IgG anti-Ro (SSA), and sometimes anti-La, crosses the placenta from about 16 to 24 weeks and injures the fetal conduction system, causing congenital heart block.

Why is "Anti-Smith" not the answer?

Anti-Smith is specific for SLE but is not linked to neonatal heart block.

Why is "Anti-double-stranded DNA" not the answer?

Anti-dsDNA relates to lupus nephritis and does not cause congenital block.

Why is "Anti-centromere" not the answer?

Anti-centromere is associated with limited systemic sclerosis.

What concept does this question test?

It tests Rheumatology: neonatal lupus in General Medicine. The mother may be asymptomatic. Neonatal lupus may also cause a transient rash, cytopenias and hepatic involvement.

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 Rheumatology: neonatal lupus?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.