Case-based MCQ

A 3-day-old neonate presents to the emergency department with progressive cyanosis and tachypnea. The infant appears well-developed but has persistent oxygen saturations in the mid-70s despite high-flow oxygen therapy. Physical examination reveals a single, loud S2 without murmur and normal peripheral pulses. The infant is alert and feeding adequately. A chest x-ray is obtained as part of the cardiac evaluation. Which radiographic finding would be most consistent with this clinical presentation? A. Boot-shaped cardiac silhouette with decreased pulmonary vascular markings B. Enlarged cardiac silhouette with prominent pulmonary arteries C. Normal cardiac size with increased interstitial markings D. Enlarged globular cardiac silhouette with narrow superior mediastinum E. Figure-of-eight cardiac silhouette with increased pulmonary markings

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