Cardiology: Ebstein anomaly: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Cardiology: Ebstein anomaly

Sample item

A newborn has cyanosis and a massively enlarged right atrium on chest X-ray (box-shaped heart). Maternal use of which drug during pregnancy is associated?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Lithium

Ebstein anomaly is apical displacement of the septal and posterior tricuspid leaflets, with atrialisation of the right ventricle, and has an association with maternal lithium. It is associated with WPW syndrome and supraventricular tachycardia. Cyanosis results from right-to-left atrial shunting.

Option by option

  • A. Warfarin

    Warfarin is linked to nasal hypoplasia and chondrodysplasia punctata.

  • B. Thalidomide

    Thalidomide causes limb defects.

  • C. Phenytoin

    Phenytoin is linked to fetal hydantoin syndrome.

  • D. Lithium (correct)

    Correct. Lithium is associated with Ebstein anomaly.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is D, Lithium. Ebstein anomaly is apical displacement of the septal and posterior tricuspid leaflets, with atrialisation of the right ventricle, and has an association with maternal lithium.

Why is "Warfarin" not the answer?

Warfarin is linked to nasal hypoplasia and chondrodysplasia punctata.

Why is "Thalidomide" not the answer?

Thalidomide causes limb defects.

Why is "Phenytoin" not the answer?

Phenytoin is linked to fetal hydantoin syndrome.

What concept does this question test?

It tests Cardiology: Ebstein anomaly in Pediatrics. It is associated with WPW syndrome and supraventricular tachycardia. Cyanosis results from right-to-left atrial shunting.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiology: Ebstein anomaly?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.