Cardiovascular system: Eisenmenger syndrome: practice question

A Physiology 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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Physiology · Cardiovascular system: Eisenmenger syndrome

Sample item

A 25-year-old woman with an untreated large ventricular septal defect since childhood now has cyanosis and clubbing, and the murmur has become soft. Which haemodynamic change explains the cyanosis?

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

The answer and the reasoning

B. Pulmonary vascular resistance exceeding systemic resistance, reversing the shunt

Years of left-to-right flow damage the pulmonary vessels and raise resistance. Once pulmonary pressure exceeds systemic pressure the shunt reverses to right-to-left, which causes central cyanosis and softening of the murmur.

Option by option

  • A. Obstruction to right ventricular outflow

    RV outflow obstruction describes Fallot tetralogy, a separate lesion.

  • B. Pulmonary vascular resistance exceeding systemic resistance, reversing the shunt (correct)

    Correct. Reversal of the shunt from raised pulmonary resistance causes cyanosis.

  • C. Loss of the septal defect

    The defect persists; it is the direction of flow that changes.

  • D. Increased left-to-right flow with pulmonary oedema

    A left-to-right shunt does not cause cyanosis.

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 Physiology question

What is the answer to this Physiology question?

The best answer is B, Pulmonary vascular resistance exceeding systemic resistance, reversing the shunt. Years of left-to-right flow damage the pulmonary vessels and raise resistance.

Why is "Obstruction to right ventricular outflow" not the answer?

RV outflow obstruction describes Fallot tetralogy, a separate lesion.

Why is "Loss of the septal defect" not the answer?

The defect persists; it is the direction of flow that changes.

Why is "Increased left-to-right flow with pulmonary oedema" not the answer?

A left-to-right shunt does not cause cyanosis.

What concept does this question test?

It tests Cardiovascular system: Eisenmenger syndrome in Physiology. Once pulmonary pressure exceeds systemic pressure the shunt reverses to right-to-left, which causes central cyanosis and softening of the murmur.

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 Cardiovascular system: Eisenmenger syndrome?

For each system, sketch the key graph (pressure–volume loop, oxygen dissociation curve, nephron handling) and explain it aloud. Then use the flashcards and the other Physiology 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.