This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: C.V.S., Subject name: Pediatrics
All of the following are true regarding tetralogy of Fallot except: 
Select and explain. 
A. Ejection systolic murmur in second intercostal space, B. Single second heart sound, C. Predominantly left to right shunt, D. Normal jugular venous pressure
C: Predominantly left to right shunt
Answer: C: Predominantly left to right shunt 
Explanation: c. Predominantly left to right shunt(Ref: Nelson's 20/e p 2211-2217, Ghai 8/e p 420-423)Right to left shunt is seen in ToF i.e. blood going from the pulmonary circulation to the systemic circulation Physical examination in a case of TOF shows: Cyanosis and clubbing, Normal jugular venous pulse (as there is no heart failure), a Single second heart sound (S2) and Ejection systolic murmur in pulmonary area.