A 7-Year-Old Boy Is Evaluated for Fatigue

question 413

Multiple Choice

A 7-year-old boy is evaluated for fatigue.  For the last year, he has been avoiding any significant outdoor activities with his peers due to poor energy and shortness of breath.  He also describes occasional pounding in the chest.  Physical examination shows a holosystolic murmur best heard at the lower sternal border.  Echocardiography reveals apical displacement of the tricuspid valve leaflets, decreased right ventricular volume, and atrialization of the right ventricle.  Moderate to severe tricuspid regurgitation is also present.  If this patient's diagnosis is due to a side effect of a drug taken during pregnancy, his biological mother most likely had which of the following conditions?

• A)Alcohol use disorder
• B)Bipolar disorder
• C)Cocaine use disorder
• D)Down syndrome
• E)Epilepsy
• F)Gestational diabetes
• G)Hypothyroidism
• H)Opioid use disorder
• I)Schizophrenia

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Definitions:

Tariff

A tax imposed by a government on imported goods, typically to protect domestic industries or to generate revenue.

Domestic Consumers

Persons or households in a nation acquiring goods and services for individual consumption.

Surplus

An excess of what is needed, often referring to goods, funds, or resources beyond what is used.

Tariff

A levy placed by the government on goods being imported or exported.