Paediatric surgery: neuroblastoma: practice question

A General Surgery 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 Surgery · Paediatric surgery: neuroblastoma

Sample item

A 2-year-old child has a firm irregular abdominal mass that crosses the midline, periorbital ecchymoses and bone pain. Calcification is seen on radiograph. Which test best supports the diagnosis?

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

The answer and the reasoning

C. Urinary vanillylmandelic acid and homovanillic acid

Neuroblastoma arises from neural crest cells of the adrenal medulla or sympathetic chain, with stippled calcification, midline crossing and encasement of vessels. Raised urinary catecholamine metabolites (VMA and HVA) support the diagnosis, and biopsy with MYCN testing guides risk. Periorbital bruising reflects orbital metastases.

Option by option

  • A. Serum beta-hCG

    Beta-hCG is raised in germ cell tumours such as choriocarcinoma.

  • B. Urinary 5-hydroxyindoleacetic acid

    5-HIAA is raised in carcinoid tumours.

  • C. Urinary vanillylmandelic acid and homovanillic acid (correct)

    Correct. Catecholamine metabolites are raised in most neuroblastomas.

  • D. Serum alpha-fetoprotein

    AFP is raised in hepatoblastoma and yolk sac tumours.

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 Surgery question

What is the answer to this General Surgery question?

The best answer is C, Urinary vanillylmandelic acid and homovanillic acid. Neuroblastoma arises from neural crest cells of the adrenal medulla or sympathetic chain, with stippled calcification, midline crossing and encasement of vessels.

Why is "Serum beta-hCG" not the answer?

Beta-hCG is raised in germ cell tumours such as choriocarcinoma.

Why is "Urinary 5-hydroxyindoleacetic acid" not the answer?

5-HIAA is raised in carcinoid tumours.

Why is "Serum alpha-fetoprotein" not the answer?

AFP is raised in hepatoblastoma and yolk sac tumours.

What concept does this question test?

It tests Paediatric surgery: neuroblastoma in General Surgery. Raised urinary catecholamine metabolites (VMA and HVA) support the diagnosis, and biopsy with MYCN testing guides risk. Periorbital bruising reflects orbital metastases.

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 Paediatric surgery: neuroblastoma?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.