Nutrition: vitamin K prophylaxis in newborns: practice question

A PSM 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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PSM · Nutrition: vitamin K prophylaxis in newborns

Sample item

A home-delivered healthy term newborn is breastfed exclusively. On day 5 the baby has melaena and bleeding from the umbilical stump, with a normal platelet count. Which preventive measure at birth would have avoided this?

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

The answer and the reasoning

C. Intramuscular vitamin K

Newborns have low vitamin K stores, poor gut synthesis and little vitamin K in breast milk, so they may develop haemorrhagic disease of the newborn. A single intramuscular dose of vitamin K at birth prevents it and is standard for all neonates.

Option by option

  • A. Intramuscular vitamin D

    Vitamin D prevents rickets and has no role in coagulation.

  • B. Oral vitamin A

    Vitamin A supplementation prevents xerophthalmia, not neonatal bleeding.

  • C. Intramuscular vitamin K (correct)

    Correct. A single intramuscular dose of vitamin K at birth prevents haemorrhagic disease of the newborn.

  • D. Oral iron

    Iron does not influence coagulation factors and is not needed at birth.

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 PSM question

What is the answer to this PSM question?

The best answer is C, Intramuscular vitamin K. Newborns have low vitamin K stores, poor gut synthesis and little vitamin K in breast milk, so they may develop haemorrhagic disease of the newborn.

Why is "Intramuscular vitamin D" not the answer?

Vitamin D prevents rickets and has no role in coagulation.

Why is "Oral vitamin A" not the answer?

Vitamin A supplementation prevents xerophthalmia, not neonatal bleeding.

Why is "Oral iron" not the answer?

Iron does not influence coagulation factors and is not needed at birth.

What concept does this question test?

It tests Nutrition: vitamin K prophylaxis in newborns in PSM. A single intramuscular dose of vitamin K at birth prevents it and is standard for all neonates.

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 Nutrition: vitamin K prophylaxis in newborns?

Practise biostatistics with small calculations until sensitivity, predictive values and risk measures are automatic. Then use the flashcards and the other PSM 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.