Growth and development: non-organic failure to thrive: 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 · Growth and development: non-organic failure to thrive

Sample item

An 18-month-old with weight below the 3rd centile is withdrawn and poorly cared for. On a hospital ward eating ordinary meals, she gains 800 g in two weeks. What is the most likely explanation of her poor growth?

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

The answer and the reasoning

A. Inadequate calorie intake with psychosocial deprivation at home

Rapid catch-up gain on adequate hospital feeding proves that the child has no important organic disease and that intake at home was insufficient. Neglect and disordered feeding are the usual causes, and management addresses the family and feeding environment.

Option by option

  • A. Inadequate calorie intake with psychosocial deprivation at home (correct)

    Correct. Brisk weight gain on ordinary meals shows the problem was inadequate intake and care.

  • B. Distal renal tubular acidosis

    Renal tubular acidosis causes persistent growth failure that does not correct on diet alone.

  • C. Growth hormone deficiency

    Growth hormone deficiency affects linear growth and does not produce rapid weight gain with feeding.

  • D. Malabsorption due to coeliac disease

    Coeliac disease would continue to cause poor gain despite the same diet.

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, Inadequate calorie intake with psychosocial deprivation at home. Rapid catch-up gain on adequate hospital feeding proves that the child has no important organic disease and that intake at home was insufficient.

Why is "Distal renal tubular acidosis" not the answer?

Renal tubular acidosis causes persistent growth failure that does not correct on diet alone.

Why is "Growth hormone deficiency" not the answer?

Growth hormone deficiency affects linear growth and does not produce rapid weight gain with feeding.

Why is "Malabsorption due to coeliac disease" not the answer?

Coeliac disease would continue to cause poor gain despite the same diet.

What concept does this question test?

It tests Growth and development: non-organic failure to thrive in Pediatrics. Neglect and disordered feeding are the usual causes, and management addresses the family and feeding environment.

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 Growth and development: non-organic failure to thrive?

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.