Nutrition and malnutrition: vitamin B12 deficiency: 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 · Nutrition and malnutrition: vitamin B12 deficiency

Sample item

A 9-month-old exclusively breastfed infant of a strictly vegan mother is pale, irritable and has lost previously gained skills, with tremors, a hypersegmented neutrophil smear and a macrocytic anaemia. Which deficiency is most likely?

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

The answer and the reasoning

D. Vitamin B12

Strictly vegan mothers have low B12 stores, and their breast milk is deficient. The infant develops megaloblastic anaemia with neurological regression and tremors. Treatment is parenteral B12, and the neurological recovery may be incomplete.

Option by option

  • A. Vitamin B6

    Vitamin B6 deficiency causes seizures and a sideroblastic picture, not macrocytosis.

  • B. Iron

    Iron deficiency gives microcytic anaemia and does not cause hypersegmentation or regression.

  • C. Vitamin C

    Vitamin C deficiency causes scurvy with bleeding gums and bone pain.

  • D. Vitamin B12 (correct)

    Correct. Macrocytic anaemia, hypersegmented neutrophils and regression point to B12 deficiency.

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 D, Vitamin B12. Strictly vegan mothers have low B12 stores, and their breast milk is deficient.

Why is "Vitamin B6" not the answer?

Vitamin B6 deficiency causes seizures and a sideroblastic picture, not macrocytosis.

Why is "Iron" not the answer?

Iron deficiency gives microcytic anaemia and does not cause hypersegmentation or regression.

Why is "Vitamin C" not the answer?

Vitamin C deficiency causes scurvy with bleeding gums and bone pain.

What concept does this question test?

It tests Nutrition and malnutrition: vitamin B12 deficiency in Pediatrics. The infant develops megaloblastic anaemia with neurological regression and tremors. Treatment is parenteral B12, and the neurological recovery may be incomplete.

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 Nutrition and malnutrition: vitamin B12 deficiency?

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.