You are called to examine a 2-day old male infant due to difficulty in feeding. He becomes cyanotic and short of breath when he feeds, but turns pink when he cries. His prenatal, birth and family histories are unremarkable. His vital signs are normal. Chest auscultation is normal. His peripheral pulses are full and symmetric. What is the most likely diagnosis?
A) Cyanotic heart disease
B) Acyanotic heart disease with left-to-right shunt
C) Choanal atresia
D) Transient tachypnea of the newborn
E) Laryngomalacia
C...choanal atresia - part of CHARGE...Rx. establish airway and surgical correction
answer is C..the classic historuy is described in the q
for laryngomalacia, they will describe an epiglottis that rolls from side to sode, and mother has to feed baby in sitting position otherwise it chokes
c) Choanal atresia
The give away in this question is that the baby turns pink when he cries...babies are nose breathers....but when they cry they use their mouths...hence the obstruction is bypassed "pinking the baby up".....even is you get a question like this with abnormal cardiac findings...remember that this condition is associated with CHARGE (Coloboma, HEART DISEASE, Atresia choane, Retarded growth/development, Genital anomalies, Ear anomalies)....dont fall for the "cardiac anomaly" answer.....if the baby turns pink when it cries....it's most likely CHOANAL ATRESIA
Hey Farha is this usmleworld q from the latest 2006 subscription?