Labour and delivery: Klumpke palsy: practice question

A OBG 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.

Try it

OBG · Labour and delivery: Klumpke palsy

Sample item

A newborn delivered after a difficult breech extraction with traction has a claw hand, weak wrist and finger flexion, and ipsilateral Horner syndrome. Which injury is the most likely?

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

The answer and the reasoning

C. Lower trunk (C8-T1)

Klumpke palsy involves the lower trunk (C8-T1), giving paralysis of the small muscles of the hand and finger flexors with a claw hand, and if T1 sympathetic fibres are involved, Horner syndrome. Erb palsy affects C5-C6 and produces the waiter's tip posture.

Option by option

  • A. Fracture of the humerus

    A humeral fracture causes pain and pseudoparalysis but not a claw hand with Horner syndrome.

  • B. Phrenic nerve palsy

    Phrenic palsy causes diaphragmatic paralysis and respiratory distress, not hand deformity.

  • C. Lower trunk (C8-T1) (correct)

    Correct. A claw hand with Horner syndrome points to C8-T1 root injury.

  • D. Upper trunk (C5-C6) injury

    Erb palsy gives a limp arm in the waiter's tip posture with preserved grasp.

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.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Lower trunk (C8-T1). Klumpke palsy involves the lower trunk (C8-T1), giving paralysis of the small muscles of the hand and finger flexors with a claw hand, and if T1 sympathetic fibres are involved, Horner syndrome.

Why is "Fracture of the humerus" not the answer?

A humeral fracture causes pain and pseudoparalysis but not a claw hand with Horner syndrome.

Why is "Phrenic nerve palsy" not the answer?

Phrenic palsy causes diaphragmatic paralysis and respiratory distress, not hand deformity.

Why is "Upper trunk (C5-C6) injury" not the answer?

Erb palsy gives a limp arm in the waiter's tip posture with preserved grasp.

What concept does this question test?

It tests Labour and delivery: Klumpke palsy in OBG. Erb palsy affects C5-C6 and produces the waiter's tip posture.

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 Labour and delivery: Klumpke palsy?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG 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.