OVERVIEW
This page is dedicated to organizing various examples of standardized exam questions whose answer is tetralogy of Fallot. While this may seem a odd practice, it is useful to see multiple examples of how tetralogy of Fallot will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
KEY CHARACTERISTICS OF THIS CONDITION (ON EXAMS)
When it comes to standardized exams, each condition has its own “code” marked by key buzzwords, lab findings, clues, etc. If you are well versed in this code you will be able to more quickly identify the condition that is being discussed, and get the right answer on the exam you are taking. Below is the “code” for tetralogy of Fallot.
- Single S2
- Systolic ejection murmur (heard best over left sternal border): due to pulmonary stenosis
QUESTION EXAMPLES
Question # 1
A 5 year old male is adopted from an orphanage in Eastern Europe and brought to the US by his new parents. He is small for his age and has a bluish hue in his lips and tips of his fingers. He has clubbing and spells of cyanosis when he is squatting. A systolic ejection murmur is heard in the left third intercostal space. A chest X-ray shows a small heart, and diminished pulmonary vascular markings. A EKG shows right ventricular hypertrophy.
Question # 2
A 2 month old male is brought to the ER because he had an episode of “turning blue”. His mother had him at 40 weeks gestation without any complications. This morning he was feeding from his bottle when he became diaphoretic and cyanotic for a few minutes. There have been several episodes of this while he has been feeding or crying int he past, but they have not lasted as long. She was scared today so brought him in for evaluation. His temperature is 98.4°F, blood pressure is 90/55 mm Hg, heart are is 155, and respirations are 50. A physical exam reveals an agitated, tachypneic, and cyanotic baby. A cardiac exam demonstrates the presence of a 2/6 systolic crescendo-decrescendo murmur on the left sternal border. An echo shows the presence of a VSD as well as a pulmonary artery stenosis. The infant is placed in a knees to chest position and the cyanosis resolves. What is the likely diagnosis of this patient?
Explanation: cyanotic baby + no diagnosis at birth + heart murmur = tetralogy of Fallot
Question # 3
A 7 week old boy is brought to the ER because his mother noticed that he “turned blue“. He was born without complications. His mother was feeding him this morning from his bottle when he became diaphoretic and cyanotic for a few minutes. In the past these episodes have happened, but only briefly. His vitals are a temperature of 98.6°F, blood pressure 95/50 mm Hg, heart rate is 145 bpm, and respirations are 48/min. A physical exam reveals an agitated and cyanotic baby. Auscultation demonstrates the presence of a 2/6 crescendo-decresendo murmur at the left sternal border. What is the likely diagnosis?
Explanation: cyanotic baby + no diagnosis at birth + heart murmur = tetralogy of Fallot
Page Updated: 11.25.2016