Larynx and airway: H-type tracheoesophageal fistula: practice question

A ENT 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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ENT · Larynx and airway: H-type tracheoesophageal fistula

Sample item

A 3-month-old has recurrent coughing and choking during feeds and episodes of pneumonia. A contrast swallow is normal, but there is abdominal distension on crying. Which diagnosis may be missed?

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

The answer and the reasoning

D. H-type tracheoesophageal fistula without oesophageal atresia

An H-type fistula is a communication between the trachea and a continuous oesophagus, so the baby can swallow but aspirates. Repeated pneumonia and gaseous distension of the bowel on crying are clues. A prone pull-back tube oesophagram or bronchoscopy with oesophagoscopy confirms it.

Option by option

  • A. Vocal cord palsy

    Vocal cord palsy gives weak cry or stridor.

  • B. Laryngomalacia

    Laryngomalacia gives stridor, not feeding aspiration.

  • C. Tracheomalacia

    Tracheomalacia gives expiratory wheeze.

  • D. H-type tracheoesophageal fistula without oesophageal atresia (correct)

    Correct. The oesophagus is patent, so it presents late.

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 ENT question

What is the answer to this ENT question?

The best answer is D, H-type tracheoesophageal fistula without oesophageal atresia. An H-type fistula is a communication between the trachea and a continuous oesophagus, so the baby can swallow but aspirates.

Why is "Vocal cord palsy" not the answer?

Vocal cord palsy gives weak cry or stridor.

Why is "Laryngomalacia" not the answer?

Laryngomalacia gives stridor, not feeding aspiration.

Why is "Tracheomalacia" not the answer?

Tracheomalacia gives expiratory wheeze.

What concept does this question test?

It tests Larynx and airway: H-type tracheoesophageal fistula in ENT. Repeated pneumonia and gaseous distension of the bowel on crying are clues. A prone pull-back tube oesophagram or bronchoscopy with oesophagoscopy confirms it.

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 Larynx and airway: H-type tracheoesophageal fistula?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT 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.