Neonatology: persistent pulmonary hypertension: 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: persistent pulmonary hypertension

Sample item

A term baby with meconium aspiration has severe hypoxaemia with a pre-ductal to post-ductal saturation difference of more than 10 percent despite 100 percent oxygen. Which treatment specifically lowers pulmonary vascular resistance?

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

The answer and the reasoning

C. Inhaled nitric oxide

Persistent pulmonary hypertension of the newborn causes right-to-left shunting through the ductus and foramen ovale. Inhaled nitric oxide selectively dilates the pulmonary vessels, and sildenafil is an alternative. Indomethacin closes the ductus, which would worsen the shunt problem.

Option by option

  • A. High-dose steroids

    Steroids do not treat PPHN.

  • B. Indomethacin

    Indomethacin closes the ductus and is used for PDA.

  • C. Inhaled nitric oxide (correct)

    Correct. Inhaled nitric oxide is a selective pulmonary vasodilator.

  • D. Prostaglandin E1 infusion

    Prostaglandin E1 keeps the ductus open in duct-dependent heart disease.

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, Inhaled nitric oxide. Persistent pulmonary hypertension of the newborn causes right-to-left shunting through the ductus and foramen ovale.

Why is "High-dose steroids" not the answer?

Steroids do not treat PPHN.

Why is "Indomethacin" not the answer?

Indomethacin closes the ductus and is used for PDA.

Why is "Prostaglandin E1 infusion" not the answer?

Prostaglandin E1 keeps the ductus open in duct-dependent heart disease.

What concept does this question test?

It tests Neonatology: persistent pulmonary hypertension in Pediatrics. Inhaled nitric oxide selectively dilates the pulmonary vessels, and sildenafil is an alternative. Indomethacin closes the ductus, which would worsen the shunt problem.

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 Neonatology: persistent pulmonary hypertension?

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.