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USMLE Question of the Week

A 6-hour-old boy is evaluated in the newborn nursery due to cyanosis. The infant is cyanotic and tachypneic at rest, but turns pink when she cries. The cyanosis worsens when he attempts to feed. She is voiding normally and has passed meconium. Her prenatal, birth, and family histories are unremarkable. The infant's weight is appropriate for gestational age. Vital signs, including 4-extremity blood pressures, are normal. Examination shows a non-dysmorphic female with clear lungs and no murmurs. There are no intercostal retractions or stridor. Her peripheral pulses are full and symmetric. Which of the following is the most likely diagnosis?

A. Choanal atresia
B. Laryngomalacia
C. Tetralogy of Fallot
D. Tracheoesophageal fistula with esophageal atresia
E. Transient tachypnea of the newborn
F. Vocal cord paralysis


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