Neonatology: subcutaneous fat necrosis: 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 · Neonatology: subcutaneous fat necrosis

Sample item

A term infant who needed prolonged resuscitation at birth develops firm, violaceous nodules over the cheeks and back at 2 weeks. At 4 weeks the infant is irritable, vomits, is constipated and passes large volumes of urine. Which complication should be sought?

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

The answer and the reasoning

C. Hypercalcaemia

Subcutaneous fat necrosis follows perinatal hypoxia or cooling, and macrophage activity in the lesions produces 1,25-dihydroxyvitamin D, leading to hypercalcaemia weeks later. Vomiting, constipation, polyuria and irritability are its features, and calcium must be monitored.

Option by option

  • A. Hyperkalaemia

    Hyperkalaemia does not explain polyuria and constipation and is not linked to fat necrosis.

  • B. Hypernatraemia

    Hypernatraemia would suggest water loss and does not arise from the nodules.

  • C. Hypercalcaemia (correct)

    Correct. Hypercalcaemia may appear weeks after the nodules and explains the symptoms.

  • D. Hypermagnesaemia

    Magnesium disturbance is not a recognised complication of this condition.

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, Hypercalcaemia. Subcutaneous fat necrosis follows perinatal hypoxia or cooling, and macrophage activity in the lesions produces 1,25-dihydroxyvitamin D, leading to hypercalcaemia weeks later.

Why is "Hyperkalaemia" not the answer?

Hyperkalaemia does not explain polyuria and constipation and is not linked to fat necrosis.

Why is "Hypernatraemia" not the answer?

Hypernatraemia would suggest water loss and does not arise from the nodules.

Why is "Hypermagnesaemia" not the answer?

Magnesium disturbance is not a recognised complication of this condition.

What concept does this question test?

It tests Neonatology: subcutaneous fat necrosis in Pediatrics. Vomiting, constipation, polyuria and irritability are its features, and calcium must be monitored.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Neonatology: subcutaneous fat necrosis?

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.