A 3-Week-Old Boy Is Brought to the Emergency Department Due

question 692

Multiple Choice

A 3-week-old boy is brought to the emergency department due to a seizure.  The patient was born at term to a 23-year-old woman who had no prenatal care and delivered him at home.  The mother states that he was healthy until this morning, when he developed a low-grade fever.  The patient has been very fussy and refused to nurse at his last feed.  Subsequently, he experienced a 4-minute, generalized tonic-clonic seizure with mild perioral cyanosis.  Temperature is 38.3 C (100.9 F) .  The patient is lethargic but arouses to painful stimuli.  Pupils are equal and reactive; the anterior fontanel is full.  The remainder of the physical examination is normal.  Blood and urine samples are obtained and a lumbar puncture is performed, with results pending.  Brain imaging reveals patchy areas of increased attenuation in the cerebral cortex and edema and hemorrhage in the left temporal lobe and brainstem; no intracranial calcifications are seen.  Vertical transmission of which of the following is the most likely cause of this patient's presentation?

• A)Cytomegalovirus
• B)Group B Streptococcus
• C)Herpes simplex virus
• D)Listeria monocytogenes
• E)Toxoplasma gondii

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Definitions:

Phrenology

The idea (now discredited) that psychological strengths and weaknesses could be precisely correlated to the relative sizes of different brain areas.

Linguistic Performance

The observable use of language in communication; how well an individual can produce spoken or written language in real-life situations.

Linguistic Competence

The subconscious knowledge of grammar that allows a person to use and understand a language.

Linguistic Relativity

The hypothesis that the language one speaks influences and shapes their cognitive processes and worldview.