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Respiratory distress syndrome — MCCQE Part 1 MCQ

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ModerateNeonatal DistressRespiratory distress syndromeMCCQE Part 1

Preterm newborn at 30 weeks presents with grunting and respiratory distress soon after birth. CXR shows low lung volumes and diffuse reticulogranular pattern. Which of the following is the most appropriate next step?

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Correct answer: D — Provide CPAP/respiratory support and consider surfactant in neonatal unit

Provide CPAP/respiratory support and consider surfactant in neonatal unit is best because prematurity and early respiratory distress suggest surfactant deficiency. Provide only reassurance without clear follow-up or safety-netting is suboptimal because children can deteriorate quickly and follow-up must be explicit; Use adult dosing or adult pathways without paediatric adjustment is suboptimal because children require age- and weight-appropriate care; Delay assessment until the next routine visit is suboptimal because developmental, infectious and neonatal red flags require timely assessment; Give antibiotics, steroids or investigations routinely despite no indication is suboptimal because over-treatment can cause harm when supportive or targeted care is indicated. Antenatal steroids reduce but do not eliminate RDS risk.

Reference: Canadian Paediatric Society neonatal respiratory guidance