Child health: young infant danger signs: 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 · Child health: young infant danger signs

Sample item

A 20-day-old infant is brought with fever for one day. Axillary temperature is 38.1 degrees Celsius, respiratory rate is 52 per minute, there is no chest indrawing, and the infant is breastfeeding well and is active. How should the infant be managed under IMNCI?

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

The answer and the reasoning

C. Classify as possible serious bacterial infection, give the first dose of an injectable antibiotic and refer

In a young infant below 2 months, fever of 37.5 degrees Celsius or more (or hypothermia below 35.5) is a sign of possible serious bacterial infection, as are fast breathing of 60 per minute or more, chest indrawing, convulsions or poor feeding. The infant gets a pre-referral dose of injectable antibiotic and is referred urgently. Respiratory rate of 52 is not fast in this age group, but the fever alone is enough.

Option by option

  • A. Classify as local bacterial infection and give oral antibiotics at home

    Local bacterial infection applies to umbilical or skin pustules without systemic signs.

  • B. Reassure the mother as these findings are normal

    Fever of 38.1 degrees Celsius is abnormal in a newborn and requires action.

  • C. Classify as possible serious bacterial infection, give the first dose of an injectable antibiotic and refer (correct)

    Correct. Fever of 37.5 degrees Celsius or more in a young infant classifies as possible serious bacterial infection.

  • D. Treat the fever with paracetamol and review after two days

    Antipyretics and delay are unsafe, as sepsis can progress rapidly in this age.

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 C, Classify as possible serious bacterial infection, give the first dose of an injectable antibiotic and refer. In a young infant below 2 months, fever of 37.

Why is "Classify as local bacterial infection and give oral antibiotics at ho…" not the answer?

Local bacterial infection applies to umbilical or skin pustules without systemic signs.

Why is "Reassure the mother as these findings are normal" not the answer?

Fever of 38.1 degrees Celsius is abnormal in a newborn and requires action.

Why is "Treat the fever with paracetamol and review after two days" not the answer?

Antipyretics and delay are unsafe, as sepsis can progress rapidly in this age.

What concept does this question test?

It tests Child health: young infant danger signs in PSM. 5 degrees Celsius or more (or hypothermia below 35.5) is a sign of possible serious bacterial infection, as are fast breathing of 60 per minute or more, chest indrawing, convulsions or poor feeding. The infant gets a pre-referral dose of injectable antibiotic and is referred urgently. Respiratory rate of 52 is not fast in this age group, but the fever alone is enough.

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 Child health: young infant danger signs?

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.