<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 2-week-old newborn is brought to the physician for a follow-up examination. He was born at term and the pregnancy was uncomplicated. His mother says he has been feeding well and passing adequate amounts of urine. He appears healthy. He is at the 60th percentile for length and 40th percentile for weight. His temperature is 37.3C 99.1F, pulse is 130min, respirations are 49min and blood pressure is 6240 mm Hg. A thrill is present over the third left intercostal space. A 56 holosystolic murmur is heard over the left lower sternal border. An echocardiography shows a 3-mm membranous ventricular septal defect. Which of the following is the most appropriate next step in management?? A: Amoxicillin therapy, B: Prostaglandin E1 therapy, C: Outpatient follow-up, D: Indomethacin therapy, E: Cardiac catheterization,  <response>: This is a question about managing a newborn with a ventricular septal defect VSD. The key findings in the stem are that the newborn is otherwise healthy, growing well, and has a small 3mm VSD found incidentally on echocardiogram. He has no signs of heart failure. Choice A for amoxicillin is incorrect as there is no indication for antibiotics. Choice B for prostaglandin E1 is used to maintain ductal patency in certain congenital heart diseases, but is not indicated in an isolated small VSD with no evidence of heart failure.Choice D indomethacin is also used in certain congenital heart diseases to close the ductus arteriosus, but again is not indicated here.Choice E cardiac catheterization is an invasive procedure and not warranted in a small incidental VSD with no hemodynamic compromise.Choice C outpatient follow-up is the best option since the defect is small, the child is asymptomatic, and there are no signs of heart failure. Serial outpatient evaluation to monitor for any changes is appropriate.C: Outpatient follow-up 