Cardiology: Eisenmenger syndrome: 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: Eisenmenger syndrome

Sample item

A young adult with a large unrepaired VSD develops cyanosis, clubbing and a loud P2, with the murmur disappearing. What has happened?

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

The answer and the reasoning

A. Pulmonary hypertension with shunt reversal

In Eisenmenger syndrome chronic left-to-right shunting leads to pulmonary vascular disease, equalisation of pressures and reversal to a right-to-left shunt. Surgical closure is then contraindicated. Management is supportive, with pulmonary vasodilators.

Option by option

  • A. Pulmonary hypertension with shunt reversal (correct)

    Correct. Shunt reversal from pulmonary hypertension.

  • B. Development of aortic regurgitation

    Aortic regurgitation gives a diastolic murmur.

  • C. Infective endocarditis

    Endocarditis causes fever and embolic phenomena.

  • D. Spontaneous closure of VSD

    Closure would not cause cyanosis.

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, Pulmonary hypertension with shunt reversal. In Eisenmenger syndrome chronic left-to-right shunting leads to pulmonary vascular disease, equalisation of pressures and reversal to a right-to-left shunt.

Why is "Development of aortic regurgitation" not the answer?

Aortic regurgitation gives a diastolic murmur.

Why is "Infective endocarditis" not the answer?

Endocarditis causes fever and embolic phenomena.

Why is "Spontaneous closure of VSD" not the answer?

Closure would not cause cyanosis.

What concept does this question test?

It tests Cardiology: Eisenmenger syndrome in Pediatrics. Surgical closure is then contraindicated. Management is supportive, with pulmonary vasodilators.

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: Eisenmenger syndrome?

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.