A 1-Day-Old Boy Is in the Neonatal Intensive Care Unit

A 1-day-old boy is in the neonatal intensive care unit due to congenital anomalies noted at birth.  The infant was born vaginally at 36 weeks gestation to a 25-year-old woman, gravida 2 para 2, who declined prenatal testing and reported decreased fetal movement in the week preceding delivery.  The infant was not latching well for the first 24 hours but has urinated and stooled.  Examination shows a small face and jaw with a prominence on the back of the head.  The oral mucosa is pink, but the hands and feet are mildly cyanotic.  There are no skin creases on the palmar aspect of the digits.  There is overlapping of the fingers bilaterally along with convexity of bilateral soles and limited hip abduction.  A murmur at the left lower sternal border is heard on auscultation.  Which of the following cardiovascular abnormalities is most likely present in this patient?

A) Atrial septal defect
B) Congenital atrioventricular block
C) Patent ductus arteriosus
D) Transposition of the great arteries
E) Truncus arteriosus
F) Ventricular septal defect

Correct Answer:

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