Congenital heart disease: PDA: 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 · Congenital heart disease: PDA

Sample item

A preterm infant of 30 weeks has a continuous machinery-like murmur at the left infraclavicular area, bounding pulses and a hyperdynamic precordium on day 4. Which drug is used to close the defect?

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

The answer and the reasoning

B. Indomethacin or ibuprofen

In a preterm infant, a patent ductus arteriosus often closes with a prostaglandin synthesis inhibitor (indomethacin or ibuprofen) or paracetamol, because prostaglandins keep the ductus open. Prostaglandin E1 does the opposite and is used to keep the duct open in duct-dependent circulations. Surgical ligation is used when drug therapy fails.

Option by option

  • A. Prostaglandin E1 infusion

    Prostaglandin E1 maintains ductal patency and would worsen the shunt.

  • B. Indomethacin or ibuprofen (correct)

    Correct. Inhibiting prostaglandins promotes ductal closure.

  • C. Digoxin

    Digoxin does not close the ductus.

  • D. Spironolactone

    Spironolactone is not used to close the ductus.

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 B, Indomethacin or ibuprofen. In a preterm infant, a patent ductus arteriosus often closes with a prostaglandin synthesis inhibitor (indomethacin or ibuprofen) or paracetamol, because prostaglandins keep the ductus open.

Why is "Prostaglandin E1 infusion" not the answer?

Prostaglandin E1 maintains ductal patency and would worsen the shunt.

Why is "Digoxin" not the answer?

Digoxin does not close the ductus.

Why is "Spironolactone" not the answer?

Spironolactone is not used to close the ductus.

What concept does this question test?

It tests Congenital heart disease: PDA in Pediatrics. Prostaglandin E1 does the opposite and is used to keep the duct open in duct-dependent circulations. Surgical ligation is used when drug therapy fails.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Congenital heart disease: PDA?

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.