Substance use: neonatal abstinence syndrome: practice question

A Psychiatry 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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Psychiatry · Substance use: neonatal abstinence syndrome

Sample item

A 2-day-old term baby of a mother who used heroin throughout pregnancy has a high-pitched cry, tremors, sneezing, yawning, poor feeding, loose stools and excessive sucking. If drug treatment is needed, which is appropriate?

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

The answer and the reasoning

C. Oral morphine in tapering doses

Neonatal abstinence syndrome from opioids is treated supportively first (swaddling, small frequent feeds, minimal stimulation). If scores stay high, an opioid such as oral morphine or methadone is given and tapered slowly over days to weeks.

Option by option

  • A. Intramuscular chlorpromazine

    Chlorpromazine lowers the seizure threshold and is not recommended for neonatal withdrawal.

  • B. Intravenous naloxone

    Naloxone would precipitate abrupt, severe withdrawal and seizures in the opioid-exposed neonate.

  • C. Oral morphine in tapering doses (correct)

    Correct. Replacing the opioid and tapering it gently controls the neonatal withdrawal.

  • D. Haloperidol

    Haloperidol does not treat the autonomic and gastrointestinal features and can cause dystonia.

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 Psychiatry question

What is the answer to this Psychiatry question?

The best answer is C, Oral morphine in tapering doses. Neonatal abstinence syndrome from opioids is treated supportively first (swaddling, small frequent feeds, minimal stimulation).

Why is "Intramuscular chlorpromazine" not the answer?

Chlorpromazine lowers the seizure threshold and is not recommended for neonatal withdrawal.

Why is "Intravenous naloxone" not the answer?

Naloxone would precipitate abrupt, severe withdrawal and seizures in the opioid-exposed neonate.

Why is "Haloperidol" not the answer?

Haloperidol does not treat the autonomic and gastrointestinal features and can cause dystonia.

What concept does this question test?

It tests Substance use: neonatal abstinence syndrome in Psychiatry. If scores stay high, an opioid such as oral morphine or methadone is given and tapered slowly over days to weeks.

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 Substance use: neonatal abstinence syndrome?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry 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.