Congenital Heart defect

Prep for USMLE Forum

» Log in | Register

Forum

Step 1

Match

Prep4USMLE Forum » USMLE Step 1 Forum » Pathology Forum

Congenital Heart defect

Author

9 Posts

jean robert
Forum Guru
avatar

Topics: 161
Posts: 663

12/26/07 - 04:06 PM

A 38 y.o. XX with history of Type 2 DM gives birth to a term male infant. Immediately after birth the infant is noted to be cyanotic and tachypneic.His hypoxemia quickly worsens over minutes and he s taken to cardiac catheterization where a balloon is guided to perforate the atrial septum. He s also given an infusion of PGE1.The infant s hypoxia stabilizes and he s later taken for definitive ,corrective surgery.Which of the following is the underlying pathophysiology of this infant s hypoxemia?

a.-Coarctation of the Aorta

b.-Concomitant VSD

c.-Delayed closure of Ductus arteriosus

d.-Failure of the aorticopulmonary septum to spiral

e.-Overriding Aorta

___________________
Great works are performed not by strength, but by perseverance.

Aashi
Forum Moderator
avatar

Topics: 112
Posts: 918

12/26/07 - 04:34 PM

D-Failure of the aorticopulmonary septum to spiral---------------->Associated with GDM

Edited by Aashi on 12/26/07 - 10:04 PM

___________________
"Obstacles are those frightful things you see when you take your EYES off your goal."

new_n_lost
Politically InCorrect
avatar

Topics: 650
Posts: 6,058

12/26/07 - 05:40 PM

e.-Overriding Aorta

This is most likely a child with ToF where there are no cardio protective shunts Therefore the stem specifically mentions that they had to perforate the Atrial Septum and give him an infusion of PGE1 which means they gave him the 2 cardio protective shunts required i.e. ASD and PDA ref Goljan pg 182. Goljan also mentions in his lectures that there is a association between Diabetic mothers and Transposition of Great vessels. This could be that too.

Damn this question really is good.

___________________
FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."

angel23
Forum Guru
avatar

Topics: 34
Posts: 666

12/26/07 - 05:42 PM

Tiff
Forum Guru

Topics: 54
Posts: 563

12/26/07 - 08:04 PM

Tetralogy of Fallot - Choice E - overriding aorta

GoodGirl
.
avatar

Topics: 92
Posts: 1,189

12/26/07 - 08:33 PM

E,

___________________
http://www.youtube.com/watch?v=a5pnDDDzpqg&featur...

arlete
Intern in 2009!!!!!
avatar

Topics: 30
Posts: 2,208

12/26/07 - 09:29 PM

D - leading to transposition of great arteries (TGA)

T4F would have to have a very, very bad anatomy to give such drastic symptoms in such a short period after birth; most of the times, the cyanosis manifests only during feeding.

___________________
When men make the rules, God decides the exceptions.

drgho
Forum Junior

Topics: 1
Posts: 115

12/27/07 - 01:09 AM

jean robert
Forum Guru
avatar

Topics: 161
Posts: 663

12/27/07 - 09:59 PM

Aashi wrote:
D-Failure of the aorticopulmonary septum to spiral---------------->Associated with GDM

Correct Answer: D

GDM-------------------------------->Transposition of great vessels due to Failure of the aorticopulmonary septum to spiral

___________________
Great works are performed not by strength, but by perseverance.

You don't have permission to post.