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Medical Emergencies · single question

A child with surgically repaired Tetralogy of Fallot needs restorative treatment. What is the most appropriate step?

  1. Refer to a hospital operating room for all care
  2. Give antibiotic prophylaxis indefinitely for all procedures
  3. Proceed without any consultation — repair eliminates all risk
  4. Consult the pediatric cardiologist before treatment
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Correct answer: D. Consult the pediatric cardiologist before treatment

  • A. Hospital-based care may be needed for some patients but is not the default step; the consult comes first.
  • B. Indefinite prophylaxis is only indicated when prosthetic material or residual defect adjacent to the patch persists — that is exactly what the consult determines.
  • C. Repair does not automatically eliminate risk; residual shunts and prosthetic material carry ongoing endocarditis risk.
  • D. Correct. Prophylaxis after repair depends on whether prosthetic material or a residual defect is present, and whether the repair was within the last 6 months. Only the cardiologist can supply that detail — consult first.

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