A 2-Month-Old Girl Is Brought to the Office Due to Restricted

question 127

Multiple Choice

A 2-month-old girl is brought to the office due to restricted movements of her upper and lower extremities with swelling of the wrist and knee joints for a week.  She was born at 38 weeks gestation via an uncomplicated vaginal delivery and had an unremarkable neonatal course with no history of birth trauma or excessive bleeding.  The mother had inconsistent prenatal care.  The patient is exclusively breastfed.  Examination shows swelling with no warmth or erythema of the bilateral wrist and knee joints.  Spontaneous limb movements are decreased; the patient cries on passive movement of the joints.  Mild pallor, generalized lymphadenopathy, and hepatosplenomegaly are present.  X-rays of the wrist and knee joints reveal metaphyseal erosions with periosteal reaction.  Which of the following is the most likely cause of this patient's illness?

• A)Chlamydia infection through an infected cervix at birth
• B)HIV infection through breastfeeding
• C)Staphylococcus aureus through nosocomial transmission
• D)Transplacental transmission of a spirochete
• E)Transplacental transmission of a tachyzoite

---

Definitions:

Overly Supervision

An excessive level of oversight and control by managers or supervisors over the work and decisions of their subordinates.

Budget Expansion

An increase in allocated funds or resources for a project, department, or entire organization.

Socialized Charismatic Power

A form of leadership in which the leader's influence derives from their ethical behavior, altruism, and personal actions that benefit others.

Collective Benefit

Collective benefit refers to advantages or gains that accrue to a group, community, or society as a whole, rather than only to individual members.