Nutrition: beriberi prevention: 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: beriberi prevention

Sample item

A 35-year-old man from a community that lives mainly on highly polished rice has symmetric foot drop, calf tenderness and loss of ankle reflexes. Which community measure best prevents this condition?

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

The answer and the reasoning

B. Encouraging parboiled or lightly milled rice

The picture is dry beriberi from thiamine deficiency, which is common where polished rice is the staple. Thiamine is concentrated in the rice bran, and parboiling drives it into the endosperm, so parboiled or lightly milled rice retains more of it. Thiamine is water soluble and heat labile, and is destroyed in alkaline conditions.

Option by option

  • A. Washing the rice repeatedly before cooking

    Repeated washing removes water-soluble thiamine from the grain and worsens the deficiency.

  • B. Encouraging parboiled or lightly milled rice (correct)

    Correct. Parboiled or undermilled rice keeps thiamine in the grain.

  • C. Discarding the cooking water after boiling rice

    Discarding the cooking water throws away the thiamine that has leached out into it.

  • D. Adding baking soda while cooking the rice

    Alkaline baking soda destroys thiamine, so it would worsen the loss.

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.

More PSM questions

Questions about this PSM question

What is the answer to this PSM question?

The best answer is B, Encouraging parboiled or lightly milled rice. The picture is dry beriberi from thiamine deficiency, which is common where polished rice is the staple.

Why is "Washing the rice repeatedly before cooking" not the answer?

Repeated washing removes water-soluble thiamine from the grain and worsens the deficiency.

Why is "Discarding the cooking water after boiling rice" not the answer?

Discarding the cooking water throws away the thiamine that has leached out into it.

Why is "Adding baking soda while cooking the rice" not the answer?

Alkaline baking soda destroys thiamine, so it would worsen the loss.

What concept does this question test?

It tests Nutrition: beriberi prevention in PSM. Thiamine is concentrated in the rice bran, and parboiling drives it into the endosperm, so parboiled or lightly milled rice retains more of it. Thiamine is water soluble and heat labile, and is destroyed in alkaline conditions.

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 Nutrition: beriberi prevention?

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.