Pathology MCQ 8

Pathology MCQ8:
A 27-year-old woman gives birth to a term infant after  an uncomplicated pregnancy and delivery. The infant is cyanotic at birth. Two months later, physical examination shows the infant to be at the 37th percentile for height and weight.The representative gross appearance of the infant’s heart is shown in the figure. What is the most likely diagnosis?

A Aortic stenosis
B Pulmonic stenosis
C Tetralogy of Fallot
D Transposition of the great vessels
E Truncus arteriosus
Explanation:
The figure shows that the aorta emerges from the right ventricle, and the pulmonic trunk exits the left ventricle, consistent with complete transposition of the great vessels. Unless there is another anomalous connection between the pulmonary and systemic circulations, this condition is incompatible with extrauterine life.

The most common additional anomalous connections would be ventricular septal defect, patent ductus arteriosus, and patent foramen ovale (or atrial septal defect). In pulmonic and aortic stenosis, the great arteries are normally positioned, but small. In tetralogy of Fallot, the aorta overrides a ventricular septal defect, but is not transposed. In truncus arteriosus, the spiral septum that embryologically separates the great arteries does not develop properly.
So,  the correct option is D.
(Image credit:cram.com)

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