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Respiratory distress syndrome — RACP Paediatrics MCQ

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ModerateNeonatologyRespiratory distress syndromeRACP Paediatrics

A male infant born at 29 weeks' gestation develops tachypnoea, grunting and increasing oxygen requirement within 20 minutes of birth. He has intercostal recession and fine inspiratory crackles. Chest radiograph shows low lung volumes with diffuse reticulogranular change and air bronchograms. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Respiratory distress syndrome

Respiratory distress syndrome is most likely because the infant is very preterm, symptomatic from birth and has low-volume lungs with a ground-glass pattern. Transient tachypnoea usually occurs in term or late preterm infants with hyperinflation and fluid in the fissures. The teaching point is that timing, gestation and lung volume on X-ray help separate surfactant deficiency from retained fetal lung fluid.

Reference: RACP Knowledge Guides; RCH Neonatal respiratory distress guideline