Paediatric surgery: bronchial foreign body: 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: bronchial foreign body

Sample item

A 2-year-old choked on peanuts and now has unilateral wheeze. An expiratory chest radiograph shows the right lung remaining hyperinflated, with the mediastinum shifting to the left. What is the next best step?

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

The answer and the reasoning

A. Rigid bronchoscopy under general anaesthesia

Aspirated peanuts cause a ball-valve effect with air trapping that is more obvious on expiratory films. The standard treatment is removal by rigid bronchoscopy under general anaesthesia, which gives a secure airway and allows grasping instruments. Delay risks airway obstruction and distal infection.

Option by option

  • A. Rigid bronchoscopy under general anaesthesia (correct)

    Correct. Rigid bronchoscopy is the method for retrieving a bronchial foreign body in a child.

  • B. Flexible bronchoscopy under sedation for removal

    Flexible bronchoscopy is mainly diagnostic and is not the preferred way to remove a foreign body in a small child.

  • C. Nebulised bronchodilators and observation

    Bronchodilators do not relieve obstruction by an inhaled foreign body and delay retrieval.

  • D. CT scan of the chest

    CT adds delay and radiation, and the history and radiograph already establish the need for bronchoscopy.

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 General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Rigid bronchoscopy under general anaesthesia. Aspirated peanuts cause a ball-valve effect with air trapping that is more obvious on expiratory films.

Why is "Flexible bronchoscopy under sedation for removal" not the answer?

Flexible bronchoscopy is mainly diagnostic and is not the preferred way to remove a foreign body in a small child.

Why is "Nebulised bronchodilators and observation" not the answer?

Bronchodilators do not relieve obstruction by an inhaled foreign body and delay retrieval.

Why is "CT scan of the chest" not the answer?

CT adds delay and radiation, and the history and radiograph already establish the need for bronchoscopy.

What concept does this question test?

It tests Paediatric surgery: bronchial foreign body in General Surgery. The standard treatment is removal by rigid bronchoscopy under general anaesthesia, which gives a secure airway and allows grasping instruments. Delay risks airway obstruction and distal infection.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: bronchial foreign body?

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.