Neonatal jaundice: exchange transfusion: 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.

Try it

Pediatrics · Neonatal jaundice: exchange transfusion

Sample item

A newborn of an Rh-negative mother with a positive direct Coombs test needs exchange transfusion. Which blood is chosen?

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

The answer and the reasoning

B. Rh-negative blood of the baby's ABO group, cross-matched with the mother's blood

In Rh haemolytic disease the baby's cells carry the Rh antigen and maternal anti-D IgG is in the baby's circulation. Rh-negative blood avoids further haemolysis and is cross-matched against the mother's serum. If the baby's ABO group is compatible it is used, otherwise group O Rh-negative is chosen.

Option by option

  • A. Packed cells of the mother only

    Maternal cells would be Rh-negative but cannot be taken directly and a mother's blood is not used as a donor in this way.

  • B. Rh-negative blood of the baby's ABO group, cross-matched with the mother's blood (correct)

    Correct. Rh-negative blood compatible with the baby and the mother's serum.

  • C. Rh-positive blood of the baby's group

    Rh-positive blood would be destroyed by maternal anti-D.

  • D. Rh-negative blood of group A regardless of baby's group

    Group A blood can be incompatible if the baby is group O.

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.

More Pediatrics questions

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is B, Rh-negative blood of the baby's ABO group, cross-matched with the mother's blood. In Rh haemolytic disease the baby's cells carry the Rh antigen and maternal anti-D IgG is in the baby's circulation.

Why is "Packed cells of the mother only" not the answer?

Maternal cells would be Rh-negative but cannot be taken directly and a mother's blood is not used as a donor in this way.

Why is "Rh-positive blood of the baby's group" not the answer?

Rh-positive blood would be destroyed by maternal anti-D.

Why is "Rh-negative blood of group A regardless of baby's group" not the answer?

Group A blood can be incompatible if the baby is group O.

What concept does this question test?

It tests Neonatal jaundice: exchange transfusion in Pediatrics. Rh-negative blood avoids further haemolysis and is cross-matched against the mother's serum. If the baby's ABO group is compatible it is used, otherwise group O Rh-negative is chosen.

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 Neonatal jaundice: exchange transfusion?

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.