Haematology: practice question

A General Medicine 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

General Medicine · Haematology

Sample item

A 60-year-old woman has macrocytic anaemia, a sore smooth tongue, tingling in both feet and loss of vibration sense. Serum vitamin B12 is low. Which treatment is most appropriate?

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

The answer and the reasoning

D. Parenteral vitamin B12

Vitamin B12 deficiency with neurological involvement, as in subacute combined degeneration, needs parenteral B12, which bypasses the absorption defect of pernicious anaemia. Folic acid alone can correct the blood picture while the neurological damage progresses. Treatment is usually life-long when the cause is pernicious anaemia.

Option by option

  • A. Folic acid alone

    Folic acid alone may improve the anaemia but allows the neuropathy to worsen.

  • B. Oral prednisolone

    Steroids are not first-line for B12 deficiency, and replacement of the vitamin is required.

  • C. Oral iron

    Iron corrects iron deficiency, which is not the problem in this macrocytic picture.

  • D. Parenteral vitamin B12 (correct)

    Correct. Injected B12 replenishes stores and halts neurological deterioration.

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 General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Parenteral vitamin B12. Vitamin B12 deficiency with neurological involvement, as in subacute combined degeneration, needs parenteral B12, which bypasses the absorption defect of pernicious anaemia.

Why is "Folic acid alone" not the answer?

Folic acid alone may improve the anaemia but allows the neuropathy to worsen.

Why is "Oral prednisolone" not the answer?

Steroids are not first-line for B12 deficiency, and replacement of the vitamin is required.

Why is "Oral iron" not the answer?

Iron corrects iron deficiency, which is not the problem in this macrocytic picture.

What concept does this question test?

It tests Haematology in General Medicine. Folic acid alone can correct the blood picture while the neurological damage progresses. Treatment is usually life-long when the cause is pernicious anaemia.

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 Haematology?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.