Respiratory distress, copious oral secretions, and an inability to pass an orogastric tube are concerning for a tracheoesophageal fistula. Choanal atresia is suggested by the inability to pass a nasogastric tube. Tracheoesophageal fistula, choanal atresia, micro-ophthalmia, and genital defects, such as micropenis, are most consistent with a diagnosis of CHARGE syndrome, which is a genetic disorder. CHARGE stands for coloboma, heart anomalies, choanal atresia, retardation of growth and development, and genital and ear anomalies. Genetic testing would have to be performed to establish the diagnosis. VACTERL is characterized by vertebral anomalies, anal atresia, cardiac defects, tracheoesophageal fistula, renal anomalies, and limb anomalies. TORCH is not a syndrome but rather a collection of infections that can cause birth defects if contracted while pregnant. Trisomy 18 is a chromosomal abnormality that may present with tracheoesophageal fistula but which does not explain the other findings.