Systemic paediatrics: Wolff-Parkinson-White syndrome: practice question

A Pediatrics 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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Pediatrics · Systemic paediatrics: Wolff-Parkinson-White syndrome

Sample item

A 12-year-old has sudden-onset palpitations at a rate of about 200 per minute that last for minutes. Resting ECG between episodes shows a short PR interval and a slurred upstroke of the QRS. What is the mechanism of the tachycardia?

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

The answer and the reasoning

A. Re-entry circuit using an accessory AV pathway

Wolff-Parkinson-White syndrome is pre-excitation through an accessory pathway (bundle of Kent), shown by a short PR and delta wave. The commonest tachycardia is orthodromic AV re-entry, conducting down the AV node and back up the accessory pathway. Vagal manoeuvres and adenosine terminate it, and radiofrequency ablation is curative.

Option by option

  • A. Re-entry circuit using an accessory AV pathway (correct)

    Correct. An accessory pathway creates an AV re-entrant circuit.

  • B. Triggered activity from prolonged repolarisation

    Triggered activity from long repolarisation causes torsades de pointes.

  • C. Re-entry around a ventricular scar

    Scar-related ventricular re-entry occurs after cardiac surgery or myocarditis, not with pre-excitation.

  • D. Enhanced automaticity of the sinoatrial node

    Sinus node automaticity gives a gradual sinus tachycardia, not abrupt episodes.

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 Pediatrics question

What is the answer to this Pediatrics question?

The best answer is A, Re-entry circuit using an accessory AV pathway. Wolff-Parkinson-White syndrome is pre-excitation through an accessory pathway (bundle of Kent), shown by a short PR and delta wave.

Why is "Triggered activity from prolonged repolarisation" not the answer?

Triggered activity from long repolarisation causes torsades de pointes.

Why is "Re-entry around a ventricular scar" not the answer?

Scar-related ventricular re-entry occurs after cardiac surgery or myocarditis, not with pre-excitation.

Why is "Enhanced automaticity of the sinoatrial node" not the answer?

Sinus node automaticity gives a gradual sinus tachycardia, not abrupt episodes.

What concept does this question test?

It tests Systemic paediatrics: Wolff-Parkinson-White syndrome in Pediatrics. The commonest tachycardia is orthodromic AV re-entry, conducting down the AV node and back up the accessory pathway. Vagal manoeuvres and adenosine terminate it, and radiofrequency ablation is curative.

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 Systemic paediatrics: Wolff-Parkinson-White syndrome?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.