Paediatric anaesthesia: congenital diaphragmatic hernia: practice question

A Anaesthesia 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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Anaesthesia · Paediatric anaesthesia: congenital diaphragmatic hernia

Sample item

A newborn with a prenatal diagnosis of left congenital diaphragmatic hernia is born with respiratory distress. Which step should be avoided?

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

The answer and the reasoning

B. Bag-and-mask ventilation

Mask ventilation inflates the stomach and intestines in the chest, which compresses the lung and mediastinum and worsens hypoxia. The neonate is therefore intubated promptly, the stomach is decompressed by a nasogastric tube, and nitrous oxide is avoided. High airway pressures are avoided to limit barotrauma to the hypoplastic lung.

Option by option

  • A. Immediate tracheal intubation

    Prompt intubation is the recommended airway management.

  • B. Bag-and-mask ventilation (correct)

    Correct. Mask ventilation distends the herniated bowel and worsens the condition.

  • C. Insertion of a nasogastric tube for decompression

    Gastric decompression is part of management.

  • D. Avoidance of nitrous oxide

    Avoiding nitrous oxide is correct because it expands the herniated bowel.

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 Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, Bag-and-mask ventilation. Mask ventilation inflates the stomach and intestines in the chest, which compresses the lung and mediastinum and worsens hypoxia.

Why is "Immediate tracheal intubation" not the answer?

Prompt intubation is the recommended airway management.

Why is "Insertion of a nasogastric tube for decompression" not the answer?

Gastric decompression is part of management.

Why is "Avoidance of nitrous oxide" not the answer?

Avoiding nitrous oxide is correct because it expands the herniated bowel.

What concept does this question test?

It tests Paediatric anaesthesia: congenital diaphragmatic hernia in Anaesthesia. The neonate is therefore intubated promptly, the stomach is decompressed by a nasogastric tube, and nitrous oxide is avoided. High airway pressures are avoided to limit barotrauma to the hypoplastic lung.

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 Paediatric anaesthesia: congenital diaphragmatic hernia?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia 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.