Transposition of the Great Vessels (TGA)

1. A newborn is diagnosed with a condition where the pulmonary artery arises from the left ventricle and the aorta arises from the right ventricle. This condition is called:

B. Transposition of the Great Vessels

2. In TGA, the relationship between systemic and pulmonary circulation is best described as:

C. No normal communication

3. Survival in newborns with TGA depends on the presence of:

B. Open PDA and ASD/PFO

4. TGA accounts for approximately what percentage of congenital heart defects?

C. 5–7%

5. TGA is more commonly seen in:

B. Males

6. Which of the following defects may be associated with TGA?

D. All of the above

7. The most common associated defect in TGA is:

B. Patent foramen ovale

8. The primary problem in TGA is:

B. Inability of blood to mix between systemic and pulmonary circulations

9. Mixing of oxygenated and deoxygenated blood occurs due to:

B. Associated defects such as ASD, VSD, PDA

10. The presence of a VSD in TGA leads to:

B. Increased pulmonary blood flow and risk of heart failure

11. High pulmonary blood flow in TGA may lead to:

B. Increased pulmonary vascular resistance

12. A newborn with TGA typically presents with:

B. Severe cyanosis soon after birth

13. Cyanosis in TGA is best described as:

B. Does not improve with oxygen

14. Cyanosis may be less severe in which condition?

B. Large VSD

15. Infants with TGA often show which feeding pattern?

B. Prolonged feeding with fatigue

16. Which respiratory symptom is commonly seen?

B. Rapid respiratory rate

17. Growth failure in TGA may appear:

B. Within 2 weeks if untreated

18. Chest X-ray in TGA typically shows:

B. Egg on a string appearance with enlarged ventricles

19. Pulmonary vascular markings in TGA are usually:

B. Increased

20. ECG findings in TGA include:

B. Right ventricular hypertrophy

21. Echocardiogram findings include:

B. Abnormal great artery positions and associated defects

22. Blood findings in TGA may include:

B. Polycythemia and increased hematocrit/hemoglobin

23. Another laboratory finding is:

B. Acidosis

24. Initial management of TGA includes:

B. Maintaining PDA with Prostaglandin E1

25. The purpose of Prostaglandin E1 is to:

B. Maintain ductus arteriosus open

26. Balloon atrial septostomy (Rashkind procedure) is done to:

B. Increase atrial blood mixing

27. The definitive surgical treatment for TGA is:

B. Arterial switch procedure

28. In arterial switch surgery, the great arteries are:

B. Transected and reattached in correct positions

29. During arterial switch, coronary arteries are:

B. Reimplanted

30. A complication of arterial switch surgery includes:

B. Narrowing at anastomosis and coronary insufficiency

31. The intra-atrial baffle procedure includes:

B. Senning or Mustard procedure

32. In Senning or Mustard procedure, the:

B. Right ventricle remains systemic pump

33. A major risk of intra-atrial baffle procedures is:

B. Right ventricular failure and rhythm disturbances

34. The Rastelli procedure is indicated for:

B. TGA with VSD and severe pulmonary stenosis

35. In the Rastelli procedure, the VSD is:

B. Closed with a baffle to the aorta

36. In the Rastelli procedure, the pulmonic valve is:

B. Closed

37. Blood flow from the right ventricle to pulmonary artery in Rastelli is maintained by:

B. Conduit

38. A limitation of the Rastelli procedure is:

B. Requires multiple conduit replacements as the child grows