All are congenital cyanotic cardiac diseases, except?

SCTIMST Staff Nurse - 2015 (Set-B)

Medical Surgical Nursing

Easy

Appeared in: SCTIMST Staff Nurse - 2015 (Set-B)

Explanation

Patent Ductus Arteriosus (PDA) is the correct answer as it is classified as an acyanotic congenital heart defect.
In PDA, a persistent opening exists between the aorta and the pulmonary artery after birth.
This leads to a left-to-right shunt, where oxygenated blood from the high-pressure aorta flows into the pulmonary artery.
This recirculation of oxygenated blood through the pulmonary circuit does not cause systemic desaturation or cyanosis, unlike right-to-left shunts.

Option A: Tetralogy of Fallot is a classic example of a cyanotic congenital heart disease.
Option B: Transposition of the great arteries is a cyanotic congenital heart disease where the systemic and pulmonary circulations are parallel, requiring a shunt for survival.
Option C: Tricuspid Atresia is a cyanotic congenital heart disease characterized by the absence of the tricuspid valve, leading to a right-to-left shunt.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Classification of congenital heart diseases (cyanotic vs. acyanotic) as background academic context rather than a clinical decision trigger.
Nurses must be able to differentiate between cyanotic and acyanotic heart defects to anticipate patient needs and potential complications. Assessment for central cyanosis (in the tongue and mucous membranes) is crucial.
Infants with cyanotic defects like Tetralogy of Fallot may experience hypercyanotic spells ('tet spells'). A key nursing intervention is to place the infant in the knee-chest position to increase systemic vascular resistance and improve pulmonary blood flow.
In certain duct-dependent cyanotic lesions (like TGA), a patent ductus arteriosus is vital for mixing blood. Nurses may administer Prostaglandin E1 infusions to keep the ductus open until surgical correction can be performed.

How to Approach the Question

First, identify the core concept of the question, which is 'congenital cyanotic cardiac diseases'.
Note the keyword 'except'. This means you are looking for the option that does NOT fit into the category of cyanotic heart disease.
Evaluate each option against the definition of a cyanotic heart defect (one that causes a right-to-left shunt of deoxygenated blood).
Recall or use mnemonics like the '5 Ts' (Tetralogy of Fallot, Transposition of Great Arteries, Tricuspid Atresia, Truncus Arteriosus, TAPVR) to quickly identify common cyanotic defects.
Identify Patent Ductus Arteriosus as an acyanotic defect (left-to-right shunt) and therefore the correct exception.

Concept Tested & Keywords

Concept Tested: Classification of congenital heart diseases (cyanotic vs. acyanotic)
Stem keywords: congenital, cyanotic, cardiac diseases
Lead-in keywords: except
Negative lead-in flag: The question asks to identify the option that is an EXCEPTION.

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E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed pp. 541-543, 542-544

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 25-33