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Hyaline membrane pathology — MRCPCH TAS MCQ

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ModeratePathologyHyaline membrane pathologyMRCPCH TAS

A 27-week preterm infant dies from severe respiratory failure. Post-mortem lung histology shows collapsed alveoli lined by eosinophilic hyaline membranes. What is the primary pathological driver?

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Correct answer: A — Surfactant deficiency causing alveolar collapse

Hyaline membrane disease is driven by surfactant deficiency, causing atelectasis and protein-rich membranes in the alveoli. Meconium aspiration has airway obstruction and chemical pneumonitis rather than classic surfactant-deficiency histology. The pearl is that antenatal corticosteroids reduce risk by promoting surfactant production.

Reference: Rennie and Robertson Textbook of Neonatology; Nelson Textbook of Pediatrics; RCPCH Theory examination syllabi