Pediatric ATI Practice Exam

Which clinical manifestation is commonly associated with transportation of great vessels?

1. Clubbing of fingers

2. Respiratory distress

3. Bounding pulses

4. Cyanosis within hours of birth

The correct answer is: Cyanosis within hours of birth

Cyanosis within hours of birth is a key clinical manifestation associated with the transportation of great vessels, also known as transposition of the great arteries (TGA). This condition occurs when the aorta and pulmonary artery are switched, leading to systemic and pulmonary circulations being separate and not properly oxygenating the blood. As a result, when the baby is born, they typically experience cyanosis due to lack of oxygenated blood circulating through the body. This early onset of cyanosis is indicative of a critical heart defect that requires prompt medical intervention to address the anatomical issues. The presence of cyanosis in the neonatal period is a red flag for severe congenital heart defects, such as TGA, necessitating immediate assessment and often surgical intervention. In contrast, clubbing of fingers is generally associated with chronic hypoxia seen in conditions like cystic fibrosis or congenital heart disease but typically develops over time, not immediately after birth. Respiratory distress can occur in many neonatal conditions, not specifically in TGA and is more often due to lung complications. Bounding pulses can indicate increased blood flow or pressure, often seen in other cardiac conditions, but do not relate directly to the critical state seen in TGA.