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Prep4USMLE Forum » USMLE Step 2 CK Forum » Pediatrics Forum

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10 Posts

Rasul
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Topics: 56
Posts: 485

05/11/06 - 07:07 PM

A cyanotic newborn is suspected of having congenital heart disease.The ECG shows left axis deviation and left vetricular hypertrophy.The most likely Ds is:
a. transposition of great vessels
b. truncus arteriosus
c. tricuspid atresia
d. tetralogy of Fallot
e. persistent fetal circulation

babli
Forum Guru

Topics: 40
Posts: 425

05/11/06 - 07:26 PM

d. tetralogy of Fallot

Rasul
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05/11/06 - 07:27 PM

Nope.

msyamp
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Topics: 60
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05/11/06 - 07:41 PM

tricuspid atresia

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Rasul
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Topics: 56
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05/11/06 - 09:13 PM

Yep!

drk1980
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Topics: 147
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05/12/06 - 03:53 AM

Rasul, sorry for my ignorance. Will appreciate some explanations...thanks!

mesh
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Topics: 77
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05/12/06 - 07:25 AM

agree with tricuspid atresia..left ventricular hypertrophy....in TOF there is right ventricular hypertrophy..

drk1980
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05/12/06 - 08:28 AM

thnks mesh! i need to wake-up, before solving Qs that is! shocked

mesh
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05/12/06 - 11:42 AM

Rasul
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Topics: 56
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05/12/06 - 10:01 PM

#10

I'm sorry I couldn't get to this forum earlier. The explanation is the following:
In tricuspid atresia there's almost no right ventrical mass (meaning, hypoplasia or no ventirle at all). Let say it's hypoplasia of RV. It often comes with VSD, and it helps the oxygenated blood to pulmonary artery. So, logically, there's supposed to be shunt left-to-right, then right-to-left...except...in the case of tricuspid atresia the RV is so small and non-complaint, it almost looks like an elongation of pulmonary arteries' starting form the defect in interventricular septum...and all the work is done by LV, pushing out blood for both of them(I hope I'm explaining it properly), so only left venticle gets hypertrophied...Basically, if You don't have right ventricle, it cannot hypertrophy...

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