Paediatric infections: neonatal varicella prevention: 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 · Paediatric infections: neonatal varicella prevention

Sample item

A term baby is born to a mother whose chickenpox rash appeared 3 days before delivery. The baby is well and has no lesions. What is the best step?

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

The answer and the reasoning

B. Give varicella-zoster immunoglobulin to the newborn as soon as possible

If maternal varicella appears from 5 days before to 2 days after delivery, the baby is exposed to a high viral load without time for protective maternal IgG to cross the placenta. Mortality in neonatal varicella is high, so VZIG is given promptly, and aciclovir is added if disease develops.

Option by option

  • A. Reassure that maternal antibody will fully protect the baby

    Too little time has passed for protective maternal antibody to be transferred.

  • B. Give varicella-zoster immunoglobulin to the newborn as soon as possible (correct)

    Correct. VZIG is indicated when maternal rash starts 5 days before to 2 days after delivery.

  • C. Give live varicella vaccine at birth

    Live vaccine is not given in the newborn period.

  • D. Discharge and start therapy only if lesions appear

    Waiting for lesions delays treatment of a disease with high neonatal mortality.

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 B, Give varicella-zoster immunoglobulin to the newborn as soon as possible. If maternal varicella appears from 5 days before to 2 days after delivery, the baby is exposed to a high viral load without time for protective maternal IgG to cross the placenta.

Why is "Reassure that maternal antibody will fully protect the baby" not the answer?

Too little time has passed for protective maternal antibody to be transferred.

Why is "Give live varicella vaccine at birth" not the answer?

Live vaccine is not given in the newborn period.

Why is "Discharge and start therapy only if lesions appear" not the answer?

Waiting for lesions delays treatment of a disease with high neonatal mortality.

What concept does this question test?

It tests Paediatric infections: neonatal varicella prevention in Pediatrics. Mortality in neonatal varicella is high, so VZIG is given promptly, and aciclovir is added if disease develops.

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 Paediatric infections: neonatal varicella prevention?

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.