Neonatology: hypoglycaemia: 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 · Neonatology: hypoglycaemia

Sample item

A 12-hour-old symptomatic term baby has a blood glucose of 20 mg/dl and is jittery. What is the best immediate treatment?

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

The answer and the reasoning

B. 2 ml/kg of 10 percent dextrose IV bolus, then glucose infusion

Symptomatic neonatal hypoglycaemia needs a mini-bolus of 2 ml/kg 10 percent dextrose followed by a continuous infusion of 6 to 8 mg/kg/min. Hypertonic 25 or 50 percent dextrose can cause rebound hypoglycaemia and phlebitis in neonates. Blood glucose is rechecked frequently.

Option by option

  • A. Glucagon only

    Glucagon is of little use in a term baby with limited glycogen stores in most settings.

  • B. 2 ml/kg of 10 percent dextrose IV bolus, then glucose infusion (correct)

    Correct. Bolus of 10 percent dextrose followed by infusion.

  • C. Oral glucose water only

    Oral glucose water is inadequate and unsafe for a symptomatic baby.

  • D. 50 percent dextrose bolus of 2 ml/kg

    Fifty percent dextrose is hyperosmolar and is not used in neonates.

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, 2 ml/kg of 10 percent dextrose IV bolus, then glucose infusion. Symptomatic neonatal hypoglycaemia needs a mini-bolus of 2 ml/kg 10 percent dextrose followed by a continuous infusion of 6 to 8 mg/kg/min.

Why is "Glucagon only" not the answer?

Glucagon is of little use in a term baby with limited glycogen stores in most settings.

Why is "Oral glucose water only" not the answer?

Oral glucose water is inadequate and unsafe for a symptomatic baby.

Why is "50 percent dextrose bolus of 2 ml/kg" not the answer?

Fifty percent dextrose is hyperosmolar and is not used in neonates.

What concept does this question test?

It tests Neonatology: hypoglycaemia in Pediatrics. Hypertonic 25 or 50 percent dextrose can cause rebound hypoglycaemia and phlebitis in neonates. Blood glucose is rechecked frequently.

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 Neonatology: hypoglycaemia?

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.