A 2 year old boy with Tetralogy of Fallot is showing the following sign:

A. Cyanosis
B. Hypertrophic left ventricle
C. Hypertrophic left atrium
D. Hypertrophic media of pulmonary arterioles
E. Hypertrophic media of pulmonary veins

The Correct Answer is A. Cyanosis


  • Most common form of cyanotic heart disease; 6-10% of all congenital heart disease.
  • Constellation of- Large Ventricle Septal Defect, Right Ventricle Outlet Track obstruction (pulmonic stenosis), Aorta override, Right Ventricle Hypertrophy.
  • Degree of cyanosis dependent on degree of Right Ventricle Outlet Track obstruction.
  • Significant RVOT obstruction presents early with cyanosis.
  • Mild RVOT obstruction presents later without cyanosis (pink TET) with murmur.
  • CXR- Boot shaped heart due to RVH.
  • Severe TET with Pulmonary Atresia.
  • Severe stenosis requires PGE to maintain pulmonary blood flow.
  • Initial palliation with systemic to pulmonary shunt in infant with small Pulmonary atresia/stenosis (early BT Shunt).
  • Primary repair in infant with well-formed pulmonary arteries (3-5 months)
  • Asymptomatic (pink) repaired later during the first year.

Meet the Author

Dr. Lawrence Kindo

I am a medical blogger who loves to share interesting health stuff. This blog is dedicated to dissemination of medical MCQs. Enjoy!