Systemic paediatrics: infantile haemangioma: 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: infantile haemangioma

Sample item

A 2-month-old has a rapidly enlarging, raised, bright red lesion on the upper eyelid that is starting to cover the pupil. Which is the first-line systemic treatment?

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

The answer and the reasoning

C. Oral propranolol

Infantile haemangiomas proliferate over the first months of life, then involute slowly. Lesions threatening vision, the airway or causing ulceration need treatment, and oral propranolol is now first-line, with topical timolol for small superficial lesions. Oral steroids were used before propranolol and are now a second option.

Option by option

  • A. Oral prednisolone

    Prednisolone is a second-line option with more side effects.

  • B. Surgical excision

    Excision is usually deferred and is not first-line for a proliferating lesion.

  • C. Oral propranolol (correct)

    Correct. Propranolol shrinks proliferating haemangiomas and is first-line for complicated lesions.

  • D. Intralesional vincristine

    Vincristine is used for rare vascular tumours with coagulopathy, not simple haemangiomas.

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 C, Oral propranolol. Infantile haemangiomas proliferate over the first months of life, then involute slowly.

Why is "Oral prednisolone" not the answer?

Prednisolone is a second-line option with more side effects.

Why is "Surgical excision" not the answer?

Excision is usually deferred and is not first-line for a proliferating lesion.

Why is "Intralesional vincristine" not the answer?

Vincristine is used for rare vascular tumours with coagulopathy, not simple haemangiomas.

What concept does this question test?

It tests Systemic paediatrics: infantile haemangioma in Pediatrics. Lesions threatening vision, the airway or causing ulceration need treatment, and oral propranolol is now first-line, with topical timolol for small superficial lesions. Oral steroids were used before propranolol and are now a second option.

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: infantile haemangioma?

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.