**Question:** Tetralogy of Fallot is characterized by following except-

A. Pulmonary stenosis
B. Ventricular septal defect (VSD)
C. Right ventricular hypertrophy (RVH)
D. Aortic stenosis

**Core Concept:** Tetralogy of Fallot is a congenital heart defect characterized by the presence of four primary abnormalities: pulmonary stenosis, ventricular septal defect (VSD), right ventricular hypertrophy (RVH), and overriding of the aorta.

**Why the Correct Answer is Right:** Aortic stenosis (Option D) is a narrowing of the aortic valve, which is a distinct condition from Tetralogy of Fallot. It is not a characteristic feature of this congenital heart defect.

**Why Each Wrong Option is Incorrect:**

A. Pulmonary stenosis (Option A) is one of the four key components of Tetralogy of Fallot, so it is not the correct answer.
B. Ventricular septal defect (VSD) is another key feature of Tetralogy of Fallot, so this option is incorrect as well.
C. Right ventricular hypertrophy (RVH) is a compensatory response to the increased workload due to the other components of Tetralogy of Fallot. While it is a part of the condition, it is not the exception.

**Why the Correct Answer is Right:** Aortic stenosis is not present in Tetralogy of Fallot, making it the correct answer among the given options.

**Clinical Pearl:** Tetralogy of Fallot is a critical congenital heart defect to understand for students studying cardiology or cardiothoracic surgery. It is essential to recognize the key components and their relationships to properly diagnose and manage this condition.