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step2ck_form8/Block 2/Question#38 (9.5 difficulty score)
A 3-day-old newborn is brought to the ...
Closure of the ductus arteriosusπŸ”,πŸ“Ί

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submitted by step_prep(84),
  • This is a classic presentation for a patient with coarctation of the aorta. When they are first born, blood is able to get past the coarctation because blood flow through the ductus arteriosus enters the aorta distal to the coarctation. When the ductus arteriosus closes in the first week of life, the left side of the heart then sees a massive increase in afterload, leading to heart failure

submitted by spiroskeet(14),

This was a poorly worded question – the underlying mechanism of the child's condition is narrowing of the aorta, causing backup into the heart and upper body. If they wanted to get at why it presented after 3 days instead of immediately, maybe just maybe they should've asked that instead.