Repeated USMLE Questions- Medical Question of the Day- 37

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Q- A 1-day-old full-term baby of a 23-year old mother who was delivered yesterday by normal vaginal delivery is coughing, choking, and ejecting the formula from his nose and mouth. He also turns blue during feeding.

What is the primary diagnosis of this boy?

A-Imperforate anus

B-Pyloric stenosis

C-Tetralogy of Fallot

D-Tracheoesophageal fistula

E-Tracheomalacia

Answer and Explanation 

A newborn with coughing, choking, and cyanosis during feeding is classic for tracheoesophageal fistula (TEF). Milk coming out of the nose and mouth suggests that swallowed feeds cannot pass normally into the stomach. The symptoms occur immediately after birth and during feeds, which is typical for TEF (often with esophageal atresia).

Imperforate anus presents with failure to pass meconium and abdominal distension, not feeding-related cyanosis. Pyloric stenosis occurs at 2–8 weeks of age with projectile, non-bilious vomiting. Tetralogy of Fallot causes cyanosis, but not specifically during feeding with choking. Tracheomalacia causes stridor and breathing difficulty, not milk regurgitation through the nose.

The correct answer is D

Key takeaway:
👉 Coughing, choking, and cyanosis during feeding in a newborn = tracheoesophageal fistula.

 

Read the Book, Repeated USMLE Questions Step 2 CK 

More Repeated USMLE Questions step 2 CK

Good luck everyone

 

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Dr Ray Makar
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47 thoughts on “Repeated USMLE Questions- Medical Question of the Day- 37”

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  23. D. Tracheoesophageal fistula

  26. D. Tracheoesophageal fistula

  33. D trams esophageal fistula

  34. Tracheoesophageal fistula. There were lung development issues during the embryonic period.

  35. Tracheoesophageal fistula

  42. D

  43. D
    TEF

  45. D
    TEF

  47. D TE Fistula

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