Paediatric surgery: congenital lobar emphysema: practice question

A General Surgery 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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General Surgery · Paediatric surgery: congenital lobar emphysema

Sample item

A 3-week-old infant has progressive tachypnoea and wheeze. A chest radiograph shows a hyperlucent left upper zone with attenuated vascular markings, compression of the adjacent lung and mediastinal shift to the right. What is the most likely diagnosis?

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

The answer and the reasoning

C. Congenital lobar emphysema

Congenital lobar emphysema is overinflation of a lobe, most often the left upper lobe, from bronchial cartilage deficiency or obstruction acting as a ball valve. It causes respiratory distress and mediastinal shift in infancy, and symptomatic infants are treated with lobectomy.

Option by option

  • A. Congenital diaphragmatic hernia

    Diaphragmatic hernia shows bowel loops in the chest with a scaphoid abdomen.

  • B. Congenital pulmonary airway malformation

    Pulmonary airway malformation shows a cystic or solid lung mass, not a uniformly hyperlucent lobe.

  • C. Congenital lobar emphysema (correct)

    Correct. A hyperlucent overinflated lobe with mediastinal shift fits congenital lobar emphysema.

  • D. Tension pneumothorax

    Tension pneumothorax shows absent lung markings and a collapsed lung rather than an overinflated lobe with vessels.

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 General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Congenital lobar emphysema. Congenital lobar emphysema is overinflation of a lobe, most often the left upper lobe, from bronchial cartilage deficiency or obstruction acting as a ball valve.

Why is "Congenital diaphragmatic hernia" not the answer?

Diaphragmatic hernia shows bowel loops in the chest with a scaphoid abdomen.

Why is "Congenital pulmonary airway malformation" not the answer?

Pulmonary airway malformation shows a cystic or solid lung mass, not a uniformly hyperlucent lobe.

Why is "Tension pneumothorax" not the answer?

Tension pneumothorax shows absent lung markings and a collapsed lung rather than an overinflated lobe with vessels.

What concept does this question test?

It tests Paediatric surgery: congenital lobar emphysema in General Surgery. It causes respiratory distress and mediastinal shift in infancy, and symptomatic infants are treated with lobectomy.

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 Paediatric surgery: congenital lobar emphysema?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.