WBR277

Author	[[PageAuthor::Sapan Patel M.B.B.S]]
Exam Type	USMLE Step 3
Main Category	Community Medical Health Center, Primary Care Office
Sub Category	Pediatrics
Prompt	Physician is called to see a newborn in the nursery because the nurse is concerned that the baby have single crease in the palm of the hand, small ears, small mouth, upward slanting eyes, wide space between the first and second toes, short hands with short fingers. Which of the following sign is most likely associated in this newborn?
Answer A	Café au lait spots
Answer A Explanation	Incorrect- This newborn is showing signs of Down syndrome. Café au lait spots are associated with neurofibromatosis.
Answer B	High arched palate
Answer B Explanation	Incorrect- This newborn is showing signs of Down syndrome. High arched palates are associated with fragile X syndrome.
Answer C	Ambiguous genitalia
Answer C Explanation	Incorrect- This newborn is showing signs of Down syndrome. Ambiguous genitalia are commonly seen in CAH.
Answer D	Hypotonia
Answer D Explanation	Correct- See explanation.
Answer E	Club feet
Answer E Explanation	Incorrect- This newborn is showing signs of Down syndrome.
Right Answer	D
Explanation	EXPLANATION: The most common finding in a newborn with Down syndrome is hypotonia. Other common findings include single palmar crease, flat facial profile, macroglossia, and wide space between the first and second toes. Hypotonia in the newborn period should prompt close evaluation and follow-up. EDUCATIONAL OBJECTIVE: The most common finding in a newborn with Down syndrome is hypotonia which should prompt close evaluation and follow-up. Educational Objective: References:
Approved	Yes
Keyword	Down syndrome
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