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': 'The most common presentation of double aortic arch in infants is ? \nSelect and explain. \nA. Dysphagia, B. Tracheal compression symptoms, C. Positional hyperemia with right upper arm oedema, D. Bleeding', 'role': 'user'}, {'content': 'Answer: B \nExplanation: Double aortic arch \n\nCongenital abnormalities of the aortic arch and its major branches result in the formation of vascular rings around the trachea and esophagus with varying degrees of compression.\nThe most common cause is a double aortic arch.\nDouble aortic arch results when right dorsal aorta persists distal to the origin of the right 7th cervical intersegmental artery.\nClinical manifestations of double aortic arch are :-\n\n\nThe age and type of presentation depend on the tightness of the ring. About 75% with a double aortic arch, 55% with a right aortic arch & abberant left subclavian artery and 95% with compression by an abberant innominate artery present in infancy with repiratory symptoms, including stridor, persistent cough and frequent respiratory illnesses.\nIf the vascular ring produces compression of the trachea and esophagus, symptoms are frequently present during infancy.\nChronic wheezing is exacerbated by crying, feeding, and flexion of the neck.\nExtension of the neck tends to relieve the noisy respiration.\nVomiting may also be a component. Affected infants may have a brassy cough, pneumonia, or sudden death from aspiration.\nOthers can present in later childhood or even as teenagers or young adults with a history of respiratory symptoms that mimic asthma or exercise-induced asthma.\nSome are diagnosed later in life after being asymptomatic during entire childhood.\nThe later the presentation, the more chances of gastrointestinal symptoms being the presenting symptoms. Symptoms like dysphagia, choking vomiting may be seen.', 'role': 'assistant'}]