Systemic paediatrics: tricuspid atresia and Ebstein anomaly: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Systemic paediatrics: tricuspid atresia and Ebstein anomaly

Sample item

A cyanosed infant has an ECG showing left axis deviation with left ventricular hypertrophy and diminished right-sided forces. Which lesion is most consistent, and which maternal drug is linked to Ebstein anomaly?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Tricuspid atresia; lithium

Cyanosis with left axis deviation is characteristic of tricuspid atresia, as the right ventricle is hypoplastic. Ebstein anomaly, with apical displacement of the tricuspid valve, is associated with maternal lithium use during pregnancy.

Option by option

  • A. Truncus arteriosus; isotretinoin

    Truncus is linked to 22q11 deletion rather than lithium.

  • B. Transposition; phenytoin

    TGA has right axis and phenytoin has other teratogenic effects.

  • C. Tetralogy of Fallot; warfarin

    TOF has right axis deviation.

  • D. Tricuspid atresia; lithium (correct)

    Correct. Tricuspid atresia has left axis, and lithium causes Ebstein anomaly.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is D, Tricuspid atresia; lithium. Cyanosis with left axis deviation is characteristic of tricuspid atresia, as the right ventricle is hypoplastic.

Why is "Truncus arteriosus; isotretinoin" not the answer?

Truncus is linked to 22q11 deletion rather than lithium.

Why is "Transposition; phenytoin" not the answer?

TGA has right axis and phenytoin has other teratogenic effects.

Why is "Tetralogy of Fallot; warfarin" not the answer?

TOF has right axis deviation.

What concept does this question test?

It tests Systemic paediatrics: tricuspid atresia and Ebstein anomaly in Pediatrics. Ebstein anomaly, with apical displacement of the tricuspid valve, is associated with maternal lithium use during pregnancy.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Systemic paediatrics: tricuspid atresia and Ebstein anomaly?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.