Vitamins and minerals: carotenaemia versus jaundice: practice question

A Biochemistry 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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Biochemistry · Vitamins and minerals: carotenaemia versus jaundice

Sample item

A toddler on a diet rich in carrots and pumpkin has yellow-orange palms and soles. The sclerae are white and the urine is of normal colour. What is the explanation?

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

The answer and the reasoning

B. Deposition of carotenoids in the skin, as in carotenaemia

Carotenaemia is a harmless yellow-orange colouring of skin, most marked on the palms, soles and nasolabial folds, due to excessive carotene intake. The sclerae are spared, which distinguishes it from jaundice, and the urine does not darken. Conversion of carotene to vitamin A is regulated, so toxicity of vitamin A does not arise from carotene.

Option by option

  • A. Unconjugated hyperbilirubinaemia

    Unconjugated bilirubin would colour the sclerae, which are white here.

  • B. Deposition of carotenoids in the skin, as in carotenaemia (correct)

    Correct. Carotene deposits in skin and spares the sclerae, so there is no jaundice.

  • C. Conjugated hyperbilirubinaemia

    Conjugated bilirubin would colour the sclerae and darken the urine.

  • D. Hypervitaminosis A with retinol toxicity

    Retinol toxicity causes headache, skin peeling and hepatotoxicity, and carotene intake does not cause it.

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 Biochemistry question

What is the answer to this Biochemistry question?

The best answer is B, Deposition of carotenoids in the skin, as in carotenaemia. Carotenaemia is a harmless yellow-orange colouring of skin, most marked on the palms, soles and nasolabial folds, due to excessive carotene intake.

Why is "Unconjugated hyperbilirubinaemia" not the answer?

Unconjugated bilirubin would colour the sclerae, which are white here.

Why is "Conjugated hyperbilirubinaemia" not the answer?

Conjugated bilirubin would colour the sclerae and darken the urine.

Why is "Hypervitaminosis A with retinol toxicity" not the answer?

Retinol toxicity causes headache, skin peeling and hepatotoxicity, and carotene intake does not cause it.

What concept does this question test?

It tests Vitamins and minerals: carotenaemia versus jaundice in Biochemistry. The sclerae are spared, which distinguishes it from jaundice, and the urine does not darken. Conversion of carotene to vitamin A is regulated, so toxicity of vitamin A does not arise from carotene.

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 Vitamins and minerals: carotenaemia versus jaundice?

Build one table of enzyme deficiency, disease, inheritance and key finding, then revise it by spaced recall. Then use the flashcards and the other Biochemistry 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.