A 10-Year-Old Boy Who Recently Immigrated from Overseas with His

question 116

Multiple Choice

A 10-year-old boy who recently immigrated from overseas with his family is brought to the office due to exertional dyspnea and fatigability.  The boy tires easily when walking and cannot keep up with his peers at the playground.  According to his parents, he was diagnosed with congenital heart disease in infancy, but corrective surgery was unavailable.  They cannot recall the details of his diagnosis.  He takes a daily multivitamin and no medications.  Pulse oximetry of the right hand shows 99% on room air.  Physical examination reveals no murmurs.  There is bilateral cyanosis and clubbing of the toes.  The fingers are normal.  All extremity pulses are full and equal.  Which of the following is the most likely diagnosis?

• A)Atrial septal defect
• B)Patent ductus arteriosus
• C)Tetralogy of Fallot
• D)Transposition of the great arteries
• E)Ventricular septal defect

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Definitions:

Behavioral Therapy

A type of psychotherapy that aims to change potentially self-destructing behaviors through the use of learning techniques.

Anxiety

A feeling of worry, nervousness, or unease typically about an imminent event or something with an uncertain outcome.

Cognitive Therapy

A type of psychotherapy that treats mental health conditions by addressing negative patterns of thought.

Decatastrophize

A cognitive-behavioral technique aimed at reducing anxiety by altering catastrophic thinking into more balanced and realistic assessments of situations.