Neonatology: congenital lobar emphysema: 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: congenital lobar emphysema

Sample item

A 2-month-old has progressive tachypnoea and a hyperinflated left chest. The radiograph shows a hyperlucent left upper zone with attenuated vascular markings, compressed left lower lobe and mediastinal shift to the right. What is the diagnosis?

ACongenital lobar emphysemaBCongenital pulmonary airway malformationCCongenital diaphragmatic herniaDLeft tension pneumothorax

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

The answer and the reasoning

A. Congenital lobar emphysema

Congenital lobar emphysema is overinflation of a lobe, most often the left upper lobe, from a check-valve obstruction of the bronchus. The lobe is hyperlucent with thin vessels, compresses adjacent lung and shifts the mediastinum. Symptomatic infants are treated with lobectomy.

Option by option

A. Congenital lobar emphysema (correct)
Correct. A hyperlucent upper lobe with attenuated vessels and mediastinal shift is typical.
B. Congenital pulmonary airway malformation
A pulmonary airway malformation appears as multicystic or solid lesions.
C. Congenital diaphragmatic hernia
A diaphragmatic hernia shows bowel loops in the chest and a scaphoid abdomen.
D. Left tension pneumothorax
A pneumothorax shows a visible lung edge and absent lung markings, not attenuated 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.

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is A, Congenital lobar emphysema. Congenital lobar emphysema is overinflation of a lobe, most often the left upper lobe, from a check-valve obstruction of the bronchus.

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

A pulmonary airway malformation appears as multicystic or solid lesions.

Why is "Congenital diaphragmatic hernia" not the answer?

A diaphragmatic hernia shows bowel loops in the chest and a scaphoid abdomen.

Why is "Left tension pneumothorax" not the answer?

A pneumothorax shows a visible lung edge and absent lung markings, not attenuated vessels.

What concept does this question test?

It tests Neonatology: congenital lobar emphysema in Pediatrics. The lobe is hyperlucent with thin vessels, compresses adjacent lung and shifts the mediastinum. Symptomatic infants are treated with lobectomy.

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: congenital lobar emphysema?

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.