Endocrinology: neonatal hyperinsulinism: 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 · Endocrinology: neonatal hyperinsulinism

Sample item

A macrosomic neonate has recurrent glucose levels below 30 mg/dl requiring glucose infusion above 12 mg/kg/min with low ketones and fatty acids. Which drug may be tried?

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

The answer and the reasoning

B. Diazoxide

Congenital hyperinsulinism causes persistent hypoglycaemia with inappropriately high insulin and low ketones. Diazoxide opens K-ATP channels and suppresses insulin release, with octreotide as second line. Mutations in KATP genes may not respond and need pancreatic surgery.

Option by option

  • A. Insulin

    Insulin would worsen hypoglycaemia.

  • B. Diazoxide (correct)

    Correct. Diazoxide suppresses insulin secretion.

  • C. Metformin

    Metformin is not used.

  • D. Glibenclamide only in toddlers

    Sulfonylureas increase insulin release.

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 B, Diazoxide. Congenital hyperinsulinism causes persistent hypoglycaemia with inappropriately high insulin and low ketones.

Why is "Insulin" not the answer?

Insulin would worsen hypoglycaemia.

Why is "Metformin" not the answer?

Metformin is not used.

Why is "Glibenclamide only in toddlers" not the answer?

Sulfonylureas increase insulin release.

What concept does this question test?

It tests Endocrinology: neonatal hyperinsulinism in Pediatrics. Diazoxide opens K-ATP channels and suppresses insulin release, with octreotide as second line. Mutations in KATP genes may not respond and need pancreatic surgery.

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 Endocrinology: neonatal hyperinsulinism?

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.