Systemic paediatrics: obstructive sleep apnoea in children: 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 · Systemic paediatrics: obstructive sleep apnoea in children

Sample item

A 5-year-old snores loudly with witnessed pauses in breathing, restless sleep and daytime hyperactivity. Examination shows grade 3 tonsils, and polysomnography confirms obstructive sleep apnoea. What is the first-line treatment?

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

The answer and the reasoning

A. Adenotonsillectomy

In children, obstructive sleep apnoea is usually due to adenotonsillar hypertrophy, so adenotonsillectomy is first-line and cures most. CPAP is for those who are not surgical candidates or have residual disease, and weight reduction helps obese children. Untreated disease causes poor growth, behavioural problems and pulmonary hypertension.

Option by option

  • A. Adenotonsillectomy (correct)

    Correct. Removing the obstructing lymphoid tissue is first-line.

  • B. Nocturnal CPAP

    CPAP is second-line for children who cannot have or fail surgery.

  • C. Tracheostomy

    Tracheostomy is a last resort for severe obstruction unresponsive to other measures.

  • D. Oral steroid course

    Steroids give only temporary benefit and are not definitive.

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, Adenotonsillectomy. In children, obstructive sleep apnoea is usually due to adenotonsillar hypertrophy, so adenotonsillectomy is first-line and cures most.

Why is "Nocturnal CPAP" not the answer?

CPAP is second-line for children who cannot have or fail surgery.

Why is "Tracheostomy" not the answer?

Tracheostomy is a last resort for severe obstruction unresponsive to other measures.

Why is "Oral steroid course" not the answer?

Steroids give only temporary benefit and are not definitive.

What concept does this question test?

It tests Systemic paediatrics: obstructive sleep apnoea in children in Pediatrics. CPAP is for those who are not surgical candidates or have residual disease, and weight reduction helps obese children. Untreated disease causes poor growth, behavioural problems and pulmonary hypertension.

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 Systemic paediatrics: obstructive sleep apnoea in children?

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.