Tetralogy of Fallot and Cyanotic Spells – 18 Board-Style Cases with Answers

What this deck covers

Tetralogy of Fallot and Cyanotic Spells in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. Same scan, different colour
2. Louder crying, fainter heart
3. Fold him up, and quiet the room
4. He stops and crouches
5. The one to leave out
6. Normal for his age, wrong for him
7. A week of fever, then a weak hand
8. Not blue, not yet
9. Buying him a few months
10. Short of breath at sixteen
11. Only the old records show it
12. Three clues from one place
13. The plan for three in the morning
14. Two kinds of blue
15. Sport, and the long view
16. Thick blood, sore head
17. Not from the hole
18. Midnight is far too early

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: How far the aorta is displaced across the wall, A chest infection has developed, It compresses the abdomen, As dilution from his large milk intake, A brain abscess, The narrowing of his outflow is still mild, Banding of the pulmonary artery, A recurrence of the narrowing below the valve, Congenital hypothyroidism, Walk him around and keep him upright, The presence of stiffening, He should limit himself to swimming and cycling, Iron deficiency, From the narrowed outflow from the right ventricle.

Clinical pearls from this deck

• Four features, but only one of them decides the colour. Look at the outflow.
• The murmur going quiet is the alarm, not the reassurance.
• Knees, oxygen, calm, morphine. Never an inotrope.
• Squatting is knees-to-chest that the child worked out for himself.
• Shock instincts kill here. Do not vasodilate and do not give an inotrope.
• In a blue child, read the haemoglobin against the saturation, never against the age range.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all Cardiology Board Questions case decks · pediatric reference values.