A post-term infant born at 41 weeks through thick meconium-stained liquor develops respiratory distress at 2 hours with cyanosis requiring supplemental oxygen. Chest X-ray shows coarse patchy infiltrates scattered across both lung fields with areas of hyperinflation and flattened diaphragms. Which feature on this radiograph BEST distinguishes this condition from respiratory distress syndrome of prematurity?
- A Presence of air bronchograms
- B Diffuse ground-glass opacification with low lung volumes
- C Hyperinflation with patchy heterogeneous opacities ✓
- D Pleural effusion in the costophrenic angles
Correct answer: C. Hyperinflation with patchy heterogeneous opacities
Explanation
Meconium causes ball-valve airway obstruction, producing air trapping, hyperinflation and coarse patchy infiltrates, often complicated by air leaks. RDS from surfactant deficiency shows uniformly reduced lung volume with fine granular ground-glass opacification and air bronchograms, so options A and B actually describe RDS rather than distinguish it. Pleural effusion is not a typical feature of either condition and points toward hydrops or infection.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.