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  #1  
Old 01-15-2015
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Default A question for usmle step 1

A 2-day-old baby girl is noted to become cyanotic whilst feeding and crying. A diagnosis of congenital heart
disease is suspected. What is the most likely cause?
A. Transposition of the great arteries
B. Coarctation of the aorta
C. Patent ductus arteriosus
D. Tetralogy of Fallot
E. Ventricular septal defect
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  #2  
Old 01-16-2015
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Quote:
Originally Posted by sohag100 View Post
A 2-day-old baby girl is noted to become cyanotic whilst feeding and crying. A diagnosis of congenital heart
disease is suspected. What is the most likely cause?
A. Transposition of the great arteries
B. Coarctation of the aorta
C. Patent ductus arteriosus
D. Tetralogy of Fallot
E. Ventricular septal defect
Let's work through this one by one.

A is wrong. Transposition of the great vessels would necessitate immediate intervention, Prostaglandin E2 administration and then I believe some sort of surgical intervention. The baby wouldn't be fine and then day 2 BAM.

B is wrong, as coarctation would cause long-term problems such as Left ventricular hypertrophy due to the increased pressure in the left ventricle. You wouldn't see the effects at day 2.

D is also wrong because the cyanosis appears immediately.

C im not sure about, but I think the cyanosis would also appear a little later than 2 days.

E I think is the correct one.

Any other opinions?
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Old 01-16-2015
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I think ans is TOF
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  #4  
Old 01-16-2015
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I think answer is E
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  #5  
Old 01-16-2015
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2-year old, cyanosis on feeding/crying = typical finding of TOF
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Old 01-16-2015
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Quote:
Originally Posted by serbanm View Post
Let's work through this one by one.

A is wrong. Transposition of the great vessels would necessitate immediate intervention, Prostaglandin E2 administration and then I believe some sort of surgical intervention. The baby wouldn't be fine and then day 2 BAM.

B is wrong, as coarctation would cause long-term problems such as Left ventricular hypertrophy due to the increased pressure in the left ventricle. You wouldn't see the effects at day 2.

D is also wrong because the cyanosis appears immediately.

C im not sure about, but I think the cyanosis would also appear a little later than 2 days.

E I think is the correct one.

Any other opinions?

VSD(isolated) is NOT a cyanotic heart disease in newborn untill Eisenmenger develops
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Old 01-16-2015
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feel it's TOF, please what is the final ans?
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Old 01-16-2015
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It's TOF period.

Stop unnecessary discussion over it.

Good luck!
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Old 01-17-2015
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Default the answer is A

guys TOF will not be present so soon, the most sever congenital heart disease is TOGV which will present one to 2 days after birth. and one guy is talking about Prostaglandin, I think He is confusing it with the PDA.
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Old 01-17-2015
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Quote:
Originally Posted by dr.ali2011 View Post
guys TOF will not be present so soon, the most sever congenital heart disease is TOGV which will present one to 2 days after birth. and one guy is talking about Prostaglandin, I think He is confusing it with the PDA.
I agree. Its AA
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  #11  
Old 01-17-2015
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TOF

TOGV is incompatible with life unless there is VSD
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Old 01-18-2015
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Quote:
Originally Posted by rnpjpb View Post
TOF

TOGV is incompatible with life unless there is VSD
or ASD, or PDA (any of them can be present commonly during the first days of life)

Transposition of great arteries is the most common cyanotic congenital heart disease in the newborn.

PS: I thought the baby was 2-years old, instead of 2-days old, so I said TOF before, but in newborn period it is very unlikely to present with cyanosis.
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Old 01-18-2015
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Quote:
Originally Posted by lnr4 View Post
or ASD, or PDA (any of them can be present commonly during the first days of life)

Transposition of great arteries is 2nd most common cyanotic congenital heart disease in the newborn.

PS: I thought the baby was 2-years old, instead of 2-days old, so I said TOF before, but in newborn period it is very unlikely to present with cyanosis.
correction
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