Neonatology: meconium ileus: 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: meconium ileus

Sample item

A term newborn has not passed meconium by 36 hours and has a distended abdomen with bilious vomiting. The abdominal film shows a ground-glass appearance with few air-fluid levels. Which underlying disease should be tested for?

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

The answer and the reasoning

C. Cystic fibrosis

Meconium ileus, in which thick sticky meconium obstructs the terminal ileum, is almost pathognomonic of cystic fibrosis. The ground-glass or soap-bubble appearance is typical, and a water-soluble contrast enema is both diagnostic and therapeutic.

Option by option

  • A. Congenital hypothyroidism

    Hypothyroidism causes constipation and prolonged jaundice, not an obstructive pattern with bubbly meconium.

  • B. Duodenal atresia

    Duodenal atresia shows a double-bubble sign with early bilious vomiting.

  • C. Cystic fibrosis (correct)

    Correct. Viscid meconium from abnormal pancreatic and intestinal secretions makes this a presentation of cystic fibrosis.

  • D. Hirschsprung disease

    Hirschsprung disease shows a transition zone on contrast study, not a ground-glass film.

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, Cystic fibrosis. Meconium ileus, in which thick sticky meconium obstructs the terminal ileum, is almost pathognomonic of cystic fibrosis.

Why is "Congenital hypothyroidism" not the answer?

Hypothyroidism causes constipation and prolonged jaundice, not an obstructive pattern with bubbly meconium.

Why is "Duodenal atresia" not the answer?

Duodenal atresia shows a double-bubble sign with early bilious vomiting.

Why is "Hirschsprung disease" not the answer?

Hirschsprung disease shows a transition zone on contrast study, not a ground-glass film.

What concept does this question test?

It tests Neonatology: meconium ileus in Pediatrics. The ground-glass or soap-bubble appearance is typical, and a water-soluble contrast enema is both diagnostic and therapeutic.

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: meconium ileus?

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.