Cardiology: heart failure in infancy: 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: heart failure in infancy

Sample item

A 6-week-old with a large VSD has tachypnoea, poor feeding, sweating on feeds and hepatomegaly. What is the usual initial medical therapy?

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

The answer and the reasoning

D. Furosemide with an ACE inhibitor, with or without digoxin

Heart failure from a left-to-right shunt is treated with diuretics, afterload reduction using captopril or enalapril, and digoxin in some centres. Adequate calories are needed for growth. Definitive treatment is surgical closure of the defect.

Option by option

  • A. Indomethacin

    Indomethacin closes a PDA, not a VSD.

  • B. Propranolol only

    Beta-blockers alone are not first line for acute failure.

  • C. Antibiotics

    Antibiotics do not treat heart failure.

  • D. Furosemide with an ACE inhibitor, with or without digoxin (correct)

    Correct. Diuretics and ACE inhibitors are first line.

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, Furosemide with an ACE inhibitor, with or without digoxin. Heart failure from a left-to-right shunt is treated with diuretics, afterload reduction using captopril or enalapril, and digoxin in some centres.

Why is "Indomethacin" not the answer?

Indomethacin closes a PDA, not a VSD.

Why is "Propranolol only" not the answer?

Beta-blockers alone are not first line for acute failure.

Why is "Antibiotics" not the answer?

Antibiotics do not treat heart failure.

What concept does this question test?

It tests Cardiology: heart failure in infancy in Pediatrics. Adequate calories are needed for growth. Definitive treatment is surgical closure of the defect.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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: heart failure in infancy?

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.