A 2-Day-Old Infant Is Dusky and Irritable

A 2-day-old infant is dusky and irritable.  He was born to a 22-year-old primigravida with sporadic prenatal care.  Delivery was uncomplicated, and Apgar scores were 7 and 8 at 1 and 5 minutes, respectively.  His temperature is 36.7 C (98 F) , blood pressure is 70/30 mm Hg, pulse is 148/min, and respiratory rate is 68/min.  Physical examination shows a cyanotic and irritable newborn with mild-to-moderate respiratory distress.  Auscultation reveals a continuous, machine-like murmur appreciated between the scapulae.  Serum lactate is elevated.  Echocardiogram shows the aorta lying anterior, inferior, and to the right of the pulmonary artery.  Failure of which of the following embryologic processes is most likely responsible for this patient's condition?

A) Apoptosis
B) Fusion
C) Obliteration
D) Proliferation
E) Septation
F) Spiraling

Correct Answer:

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