Respiratory: neonatal respiratory distress syndrome: practice question

A Pathology 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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Pathology · Respiratory: neonatal respiratory distress syndrome

Sample item

A neonate born at 30 weeks develops grunting, cyanosis and chest wall retractions within hours of birth. Radiograph shows a ground-glass pattern with air bronchograms. Which cell fails to produce enough of the deficient substance, and which antenatal intervention reduces the risk?

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

The answer and the reasoning

B. Type II pneumocytes; antenatal betamethasone

Surfactant is synthesised by type II pneumocytes and lowers alveolar surface tension, and production matures at about 34 to 36 weeks. A deficiency causes atelectasis, hypoxia and hyaline membranes composed of fibrin and necrotic cells. Antenatal corticosteroids given to mothers at risk of preterm delivery accelerate surfactant synthesis.

Option by option

  • A. Type I pneumocytes; antenatal betamethasone

    Type I pneumocytes form the thin gas-exchange surface and do not make surfactant.

  • B. Type II pneumocytes; antenatal betamethasone (correct)

    Correct. Surfactant comes from type II cells, and antenatal steroids induce its production.

  • C. Alveolar macrophages; tocolysis with nifedipine

    Alveolar macrophages clear debris and do not secrete surfactant, and tocolysis does not mature the lung.

  • D. Club cells; postnatal indomethacin

    Club cells secrete protective proteins in bronchioles, and indomethacin is used to close a ductus arteriosus.

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 Pathology question

What is the answer to this Pathology question?

The best answer is B, Type II pneumocytes; antenatal betamethasone. Surfactant is synthesised by type II pneumocytes and lowers alveolar surface tension, and production matures at about 34 to 36 weeks.

Why is "Type I pneumocytes; antenatal betamethasone" not the answer?

Type I pneumocytes form the thin gas-exchange surface and do not make surfactant.

Why is "Alveolar macrophages; tocolysis with nifedipine" not the answer?

Alveolar macrophages clear debris and do not secrete surfactant, and tocolysis does not mature the lung.

Why is "Club cells; postnatal indomethacin" not the answer?

Club cells secrete protective proteins in bronchioles, and indomethacin is used to close a ductus arteriosus.

What concept does this question test?

It tests Respiratory: neonatal respiratory distress syndrome in Pathology. A deficiency causes atelectasis, hypoxia and hyaline membranes composed of fibrin and necrotic cells. Antenatal corticosteroids given to mothers at risk of preterm delivery accelerate surfactant synthesis.

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 Respiratory: neonatal respiratory distress syndrome?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology 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.