<prompt> A child with large VSD manifests in:2 days2 weeks2 months6 months  <response>: Ans: C 2 months Ref: Pediatric Cardiology for Practitioners by Park. 4th edition, pg: 139 Nelson Textbook of Pediatrics, 19th editionExplanation:CHF develops in infants with large VSDs, but usually not until 6 to 8 weeks of age. Pediatric Cardiology for Practitioners by Park pg 139 Moderate to large VSDs produce a holosystolic murmur that is present by age 2 to 3 weeks. Ref: MerckmanualsIn children with a larger defect VSD, symptoms of HP eg, respiratory distress, poor weight gain, fatigue after feeding appear at age 4 to 6 wk when pulmonary vascular resistance fails. Ref: Merckmanuals CHF develops in large VSD, after 8 weeks of age. IAP Textbook of Pediatrics by Parthasarathy, 3rd edition; Pg: 397 