Additional: congenital diaphragmatic hernia: 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 · Additional: congenital diaphragmatic hernia

Sample item

A newborn has severe respiratory distress at birth with a scaphoid abdomen, bowel sounds in the left chest and a shift of the heart to the right. What is the initial management?

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

The answer and the reasoning

A. Endotracheal intubation and avoidance of bag-mask ventilation, with a nasogastric tube on suction

Congenital diaphragmatic hernia causes pulmonary hypoplasia and persistent pulmonary hypertension. Bag-mask ventilation fills the herniated bowel and worsens compression, so the baby is intubated, a nasogastric tube decompresses the stomach, and surgery follows stabilisation.

Option by option

  • A. Endotracheal intubation and avoidance of bag-mask ventilation, with a nasogastric tube on suction (correct)

    Correct. Intubate and decompress the stomach.

  • B. Immediate surgical repair before stabilisation

    Surgery is delayed until the infant is physiologically stable.

  • C. Bag and mask ventilation

    Bag-mask ventilation distends the herniated bowel.

  • D. CPAP with gastric distension

    CPAP also causes bowel distension.

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 A, Endotracheal intubation and avoidance of bag-mask ventilation, with a nasogastric tube on suction. Congenital diaphragmatic hernia causes pulmonary hypoplasia and persistent pulmonary hypertension.

Why is "Immediate surgical repair before stabilisation" not the answer?

Surgery is delayed until the infant is physiologically stable.

Why is "Bag and mask ventilation" not the answer?

Bag-mask ventilation distends the herniated bowel.

Why is "CPAP with gastric distension" not the answer?

CPAP also causes bowel distension.

What concept does this question test?

It tests Additional: congenital diaphragmatic hernia in Pediatrics. Bag-mask ventilation fills the herniated bowel and worsens compression, so the baby is intubated, a nasogastric tube decompresses the stomach, and surgery follows stabilisation.

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 Additional: congenital diaphragmatic hernia?

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.