Nose: congenital anomalies: 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.

Try it

ENT · Nose: congenital anomalies

Sample item

A full-term newborn is cyanosed when feeding quietly but pinks up when crying. A feeding catheter cannot be passed through either nostril. What is the diagnosis?

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

The answer and the reasoning

D. Bilateral choanal atresia

Neonates are obligate nasal breathers, so bilateral choanal atresia causes cyanosis at rest or during feeds that is relieved by crying (which opens the mouth). A catheter cannot be passed through the nose and the diagnosis is confirmed by CT or endoscopy. Immediate management is an oral airway, with later surgical repair. CHARGE syndrome may be associated.

Option by option

  • A. Diaphragmatic hernia

    Diaphragmatic hernia presents with respiratory distress and a scaphoid abdomen.

  • B. Tracheo-oesophageal fistula

    Tracheo-oesophageal fistula causes choking and cyanosis during feeding, with a nasogastric tube that coils in the pouch.

  • C. Laryngomalacia

    Laryngomalacia causes inspiratory stridor and is worse on crying.

  • D. Bilateral choanal atresia (correct)

    Correct. Cyanosis relieved by crying with impassable nasal catheters is typical.

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 ENT questions

Questions about this ENT question

What is the answer to this ENT question?

The best answer is D, Bilateral choanal atresia. Neonates are obligate nasal breathers, so bilateral choanal atresia causes cyanosis at rest or during feeds that is relieved by crying (which opens the mouth).

Why is "Diaphragmatic hernia" not the answer?

Diaphragmatic hernia presents with respiratory distress and a scaphoid abdomen.

Why is "Tracheo-oesophageal fistula" not the answer?

Tracheo-oesophageal fistula causes choking and cyanosis during feeding, with a nasogastric tube that coils in the pouch.

Why is "Laryngomalacia" not the answer?

Laryngomalacia causes inspiratory stridor and is worse on crying.

What concept does this question test?

It tests Nose: congenital anomalies in ENT. A catheter cannot be passed through the nose and the diagnosis is confirmed by CT or endoscopy. Immediate management is an oral airway, with later surgical repair. CHARGE syndrome may be associated.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Nose: congenital anomalies?

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.