skip to main content

Duct-dependent congenital heart disease — MRCPCH FOP MCQ

Instant feedback + full explanation. One question, done properly.

HardCardiologyDuct-dependent congenital heart diseaseMRCPCH FOP

A 2-day-old boy is cyanosed with oxygen saturations 78% in air and 80% on high-flow oxygen. Chest examination is clear, pulses are palpable and arterial blood gas shows metabolic acidosis. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Start prostaglandin E1 and request urgent cardiology review

Cyanosis that does not correct with oxygen and a clear chest should raise concern for cyanotic congenital heart disease, and prostaglandin may maintain ductal patency. Bronchiolitis is unlikely in a 2-day-old with clear lungs and poor oxygen response. Routine outpatient review is unsafe in an acidotic neonate. The pearl is that a hyperoxia-type response can help separate cardiac from pulmonary causes of cyanosis.

Reference: BNFc Prostaglandin E1; APLS neonatal cardiac emergencies