A 15-month-old boy is brought to the pediatrician for immunizations and assessment. His parents report that he is eating well and produces several wet diapers every day. He is occasionally fussy, but overall a happy and curious child. The boy was born at 39 weeks gestation via spontaneous vaginal delivery. On physical examination his vital signs are stable. His weight and height are above the 85th percentile for his age and sex. On chest auscultation, the pediatrician detects a loud harsh holosystolic murmur over the left lower sternal border. The first and second heart sounds are normal. An echocardiogram confirms the diagnosis of the muscular ventricular septal defect without pulmonary hypertension. Which of the following is the best management strategy for this patient?
ASurgical closure of the defect using cardiopulmonary bypass
BReassurance of the parents and regular follow-up
COral digoxin and regular follow-up
DAntibiotic prophylaxis against infective endocarditis
ETranscatheter occlusion closure of the defect
A newborn is rushed to the neonatal ICU after becoming cyanotic shortly after birth. An ultrasound is performed which shows the aorta coming off the right ventricle and lying anterior to the pulmonary artery. The newborn is given prostaglandin E1 and surgery is planned to correct the anatomic defect. Which of the following developmental processes failed to occur in the newborn?
AFailure of the membranous ventricular septum to fuse with the muscular interventricular septum
BFailure of the septum primum to fuse with the septum secundum
CFailure of the aorticopulmonary septum to spiral
DFailure of the ductus venosus to close
EFailure of the ductus arteriosus to close
A 2-week-old male newborn is brought to the physician because his mother has noticed her son has occasional bouts of ""turning blue in the face"" while crying. He also tires easily and sweats while feeding. He weighed 2150 g (4 lb 11 oz) at birth and has gained 200 g (7 oz). The baby appears mildly cyanotic. Examination shows a 3/6 systolic ejection murmur heard over the left upper sternal border. A single S2 is present. An echocardiography confirms the diagnosis. Which of the following factors is the main determinant of the severity of this patient's cyanosis?
ALeft ventricular outflow obstruction
BRight ventricular outflow obstruction
CAtrial septal defect
DRight ventricular hypertrophy
EVentricular septal defect
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