Cardiology: hypoplastic left heart: 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 · Cardiology: hypoplastic left heart

Sample item

A previously well newborn on day 3 develops cold peripheries, acidosis and shock with weak pulses as the ductus closes. Which condition is likely?

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

The answer and the reasoning

A. Ductal-dependent systemic circulation such as hypoplastic left heart syndrome

In left-sided obstructive lesions the systemic circulation depends on the ductus arteriosus, so closure produces shock at 2 to 7 days. Prostaglandin E1 infusion is started immediately. Sepsis must be considered in the differential.

Option by option

  • A. Ductal-dependent systemic circulation such as hypoplastic left heart syndrome (correct)

    Correct. Duct closure precipitates shock in left heart obstruction.

  • B. ASD

    ASD is not duct dependent.

  • C. Small VSD

    A small VSD is asymptomatic.

  • D. Tetralogy of Fallot

    Fallot causes cyanosis, not shock.

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 A, Ductal-dependent systemic circulation such as hypoplastic left heart syndrome. In left-sided obstructive lesions the systemic circulation depends on the ductus arteriosus, so closure produces shock at 2 to 7 days.

Why is "ASD" not the answer?

ASD is not duct dependent.

Why is "Small VSD" not the answer?

A small VSD is asymptomatic.

Why is "Tetralogy of Fallot" not the answer?

Fallot causes cyanosis, not shock.

What concept does this question test?

It tests Cardiology: hypoplastic left heart in Pediatrics. Prostaglandin E1 infusion is started immediately. Sepsis must be considered in the differential.

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 Cardiology: hypoplastic left heart?

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.