This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pediatrics
[{'content': 'Recurrent respiratory tract infections may occur in all of the following except – \nSelect and explain. \nA. Ventricular septal defect, B. Tetrology of Fallot, C. Transposition of great arteries, D. Total anomalous venous return', 'role': 'user'}, {'content': "Answer: B \nExplanation: Chest infections are frequent in the following two groups of congenital cardiac anomalies.\na) Left to right shunts → This group includes\n\nAtrial septal defect\nVentricular septal defect\nPatent ductus arteriosus\nThis group of CHD's are characterized by frequent chest infections.\nThere is large flow of blood in the lungs which causes lung infections.\nEach attack of cold seems to turn into Bronchopneumonia.\nIt is not uncommon for these patients to have 6-8 attacks of pneumonia in the first year of life.\n\nb)\xa0Cyanosis with increased pulmonary blood flow.\n\nA large no. of conditions result in a combination of cyanosis with increased pulmonary blood flow.\nCommon to these conditions is the presence of abnormal mixing of pulmonary venous blood with the systemic venous blood and absence of obstruction to pulmonary blood flow.\nThe anomalies included in this group are\n\n\nTransposition of great vessels\nTotal anomalous pulmonary venous connection\nSingle ventricle without obstruction to pulmonary blood flow.\nPersistent truncus arteriosus\nTricuspid atresia with absence of obstruction to pulmonary blood flow.\nDouble outlet right ventricle without pulmonary stenosis.\n\n\nClinically these patients are characterized by\n\n\nCyanosis\nCardiomegaly\nAlmost 80% of these patients are lost due to congestive cardiac failure or pulmonary infection.\n\nCongenital heart diseases which are not predisposed to pulmonary infection\n1) Right to left shunts\xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0\n\nThis group includes \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0\xa0\nTetralogy of Fallot \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0\xa0\nEbstein's anamoly\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\n\n\xa02)\xa0Obstructive lesions\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\n\nThis group includes\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\nAortic stenosis\xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0\nCoarctation of Aorta \xa0 \xa0 \xa0 \xa0 \xa0\xa0\nPulmonary stenosis\n\nCharacteristic of this group is \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0\xa0\n\nPresence of cyanosis\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\nThe absence of chest infections \xa0 \xa0 \xa0 \xa0 \xa0\n\nClinical characteristic of this group\n\nThe absence of frequent chest infections and cyanosis\nThe absence of a precordial bulge\nPresence of forcible or heaving cardiac impulse.", 'role': 'assistant'}]