Neonatology: Pierre Robin sequence: 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 · Neonatology: Pierre Robin sequence

Sample item

A newborn has a small, receding chin, a U-shaped cleft palate, and noisy breathing with retractions when lying supine that improve on turning to the side. What is the first step in management?

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

The answer and the reasoning

C. Prone or lateral positioning

In Pierre Robin sequence micrognathia pushes the tongue backwards (glossoptosis) and obstructs the airway. Prone or lateral positioning lets the tongue fall forward, and most infants improve with this and careful feeding support. Surgery such as mandibular distraction or tracheostomy is for those who fail positioning.

Option by option

  • A. Immediate tracheostomy

    Tracheostomy is reserved for failures of conservative measures.

  • B. Early cleft palate repair

    Palate repair is done later in infancy and does not relieve the airway obstruction.

  • C. Prone or lateral positioning (correct)

    Correct. Prone or lateral positioning lets the tongue fall away from the posterior pharynx.

  • D. Immediate mandibular distraction surgery

    Mandibular distraction is a later option for severe cases that fail positioning.

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 C, Prone or lateral positioning. In Pierre Robin sequence micrognathia pushes the tongue backwards (glossoptosis) and obstructs the airway.

Why is "Immediate tracheostomy" not the answer?

Tracheostomy is reserved for failures of conservative measures.

Why is "Early cleft palate repair" not the answer?

Palate repair is done later in infancy and does not relieve the airway obstruction.

Why is "Immediate mandibular distraction surgery" not the answer?

Mandibular distraction is a later option for severe cases that fail positioning.

What concept does this question test?

It tests Neonatology: Pierre Robin sequence in Pediatrics. Prone or lateral positioning lets the tongue fall forward, and most infants improve with this and careful feeding support. Surgery such as mandibular distraction or tracheostomy is for those who fail positioning.

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 Neonatology: Pierre Robin sequence?

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.