Knowledge Check: Tetralogy of Fallot
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Question 1 of 10
1. Question
Which of the following embryological defects results in the 4 classic anatomic features associated with Tetralogy of Fallot?
Hint
The 4 classic features of Tetralogy of Fallot include a ventricular septal defect, right ventricular outflow tract obstruction, right ventricular hypertrophy, and an overriding aorta.
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Question 2 of 10
2. Question
Which of the following is NOT one of the classic anatomic features of Tetralogy of Fallot?
Hint
Think about the embryological formation of this defect involving the anterior malalignment of the infundibular septum and the affected cardiac structures.
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Question 3 of 10
3. Question
You are in the clinic evaluating a patient with known Tetralogy of Fallot. The patient appears cyanotic. Which of the following anatomic lesions best explains why the patient is cyanotic?
Hint
Patients with increased resistance to blood flow out the pulmonary artery will be cyanotic due to right to left shunting of blood through the unrestricted VSD.
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Question 4 of 10
4. Question
Which of the following is NOT an effective strategy in managing a progressive hypercyanotic (“tet”) spell in a patient with Tetralogy of Fallot?
Hint
Strategies that increase cardiac mixing and systemic vascular resistance are helpful.
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Question 5 of 10
5. Question
Which of the following describes the classic chest radiograph findings of a patient with Tetralogy of Fallot?
Hint
Patients with Tetralogy of Fallot have right ventricular hypertrophy, which causes and “uplifiting” of the cardiac apex on chest radiograph, which resembles a “wooden shoe.”
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Question 6 of 10
6. Question
Which of the following is a true statement in regards to the murmurs often associated with Tetralogy of Fallot:
Hint
The classic murmur of Tetralogy of Fallot results from pulmonary stenosis.
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Question 7 of 10
7. Question
Which of the following diagnostic tests represents the gold standard for confirming the presence of Tetralogy of Fallot:
Hint
Cardiac anatomy is best visualized non-invasively by ultrasound.
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Question 8 of 10
8. Question
You are caring for a baby with Tetralogy of Fallot who has mild pulmonary stenosis and a large ventricular septal defect. Which of the following clinical presentations would be most consistent with left to right shunting across the ventricular septal defect in this patient?
Hint
Patients with Tetralogy of Fallot and mild pulmonary stenosis may present with pulmonary overcirculation and congestive heart failure.
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Question 9 of 10
9. Question
Which of the following represents the FIRST step in management of a neonate with Tetralogy of Fallot and critical pulmonary stenosis?
Hint
Tetralogy of Fallot with critical pulmonary stenosis is considered a ductal-dependent lesion.
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Question 10 of 10
10. Question
What is the typical age range for consideration of surgical repair in patients with Tetralogy of Fallot?
Hint
The exact timing of surgical repair may vary, but typically is done before the patient begins to develop signs of chronic cyanosis.