Cardiology: transposition of the great arteries: practice question

A General Medicine 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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General Medicine · Cardiology: transposition of the great arteries

Sample item

A full-term neonate is cyanosed on day 1 with a single loud second sound and no murmur. The chest radiograph shows a narrow mediastinum, an egg-on-a-string heart and increased pulmonary vascularity. What is the most important initial medical treatment?

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

The answer and the reasoning

A. Prostaglandin E1 to keep the ductus open

In transposition the pulmonary and systemic circulations run in parallel, so survival depends on mixing through a patent foramen ovale or ductus. Prostaglandin E1 keeps the ductus open until balloon atrial septostomy or the arterial switch operation is done.

Option by option

  • A. Prostaglandin E1 to keep the ductus open (correct)

    Correct. Prostaglandin E1 maintains ductal mixing so oxygenated blood reaches the systemic circuit.

  • B. High-flow oxygen to lower pulmonary resistance

    Oxygen alone does not create mixing and may promote ductal closure.

  • C. Furosemide to relieve pulmonary congestion

    Furosemide does not correct the cause of cyanosis; mixing is the problem.

  • D. Indomethacin to close the ductus arteriosus

    Indomethacin closes the ductus and would remove the life-saving shunt.

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.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Prostaglandin E1 to keep the ductus open. In transposition the pulmonary and systemic circulations run in parallel, so survival depends on mixing through a patent foramen ovale or ductus.

Why is "High-flow oxygen to lower pulmonary resistance" not the answer?

Oxygen alone does not create mixing and may promote ductal closure.

Why is "Furosemide to relieve pulmonary congestion" not the answer?

Furosemide does not correct the cause of cyanosis; mixing is the problem.

Why is "Indomethacin to close the ductus arteriosus" not the answer?

Indomethacin closes the ductus and would remove the life-saving shunt.

What concept does this question test?

It tests Cardiology: transposition of the great arteries in General Medicine. Prostaglandin E1 keeps the ductus open until balloon atrial septostomy or the arterial switch operation is done.

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 Cardiology: transposition of the great arteries?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.