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Congenital diaphragmatic hernia — MCCQE Part 1 MCQ

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ModerateNeonatal DistressCongenital diaphragmatic herniaMCCQE Part 1

A full-term neonate has moderate respiratory distress, scaphoid abdomen, decreased left breath sounds, heart displaced right. CXR: bowel loops in left hemithorax. Most appropriate immediate management?

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Correct answer: C — OG tube decompression and endotracheal intubation

CDH: bag-mask ventilation CONTRAINDICATED (distends herniated bowel). OG tube + intubation for gentle ventilation. Surgery after stabilisation (24-72h). PPHN is major complication.

Reference: CPS Neonatal Resuscitation