Paediatric emergencies: cardiac tamponade: 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 emergencies: cardiac tamponade

Sample item

A 6-year-old with a tuberculous pericardial effusion becomes restless with BP 70/50 mmHg, heart rate 160 per minute, muffled heart sounds, distended neck veins and pulsus paradoxus. What is the immediate treatment?

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

The answer and the reasoning

C. Urgent pericardiocentesis

Hypotension, muffled heart sounds, raised venous pressure and pulsus paradoxus indicate cardiac tamponade, which is a cause of obstructive shock. Urgent pericardiocentesis, ideally under echocardiographic guidance, is life-saving.

Option by option

  • A. Intravenous furosemide

    Diuretics reduce preload and worsen tamponade physiology.

  • B. Antitubercular drugs alone

    Antitubercular drugs act slowly and will not relieve an acute life-threatening effusion.

  • C. Urgent pericardiocentesis (correct)

    Correct. Draining the pericardial fluid relieves the obstruction to cardiac filling.

  • D. Digoxin loading

    Digoxin does not relieve the mechanical compression and is not indicated.

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, Urgent pericardiocentesis. Hypotension, muffled heart sounds, raised venous pressure and pulsus paradoxus indicate cardiac tamponade, which is a cause of obstructive shock.

Why is "Intravenous furosemide" not the answer?

Diuretics reduce preload and worsen tamponade physiology.

Why is "Antitubercular drugs alone" not the answer?

Antitubercular drugs act slowly and will not relieve an acute life-threatening effusion.

Why is "Digoxin loading" not the answer?

Digoxin does not relieve the mechanical compression and is not indicated.

What concept does this question test?

It tests Paediatric emergencies: cardiac tamponade in Pediatrics. Urgent pericardiocentesis, ideally under echocardiographic guidance, is life-saving.

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 Paediatric emergencies: cardiac tamponade?

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.