An 18-Hour-Old Boy Is Evaluated in the Emergency Department for Low

question 435

Multiple Choice

An 18-hour-old boy is evaluated in the emergency department for low muscle tone since birth.  He was delivered at home to a 19-year-old woman at approximately 40 weeks gestation who received no prenatal care.  Since birth, the infant has breastfed 4 times, has a weak suck each time, and falls asleep a few minutes after he begins nursing.  Weight is 2.3 kg (5.1 lb) .  The eyes have upslanting palpebral fissures, and the mouth is open with a protruding tongue.  The palate is narrow but intact.  Cardiopulmonary examination is normal.  The abdomen is soft with no hepatosplenomegaly.  When the infant is held under the arms, his legs are extended and he almost slips through the examiner's hands.  Which of the following is the most likely underlying diagnosis for this patient?

• A)Beckwith-Wiedemann syndrome
• B)Down syndrome
• C)Fragile X syndrome
• D)Infantile botulism
• E)Prader-Willi syndrome

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Definitions:

Formal Authority

Officially sanctioned power given to an individual or entity to make decisions and enforce rules.

Organizational Structure

The system that outlines how activities are directed in order to achieve the goals of an organization, including the roles, responsibilities, and hierarchy.

Legitimacy

The general perception or acceptance that an action, entity, or regime is appropriate and justified.

Negotiators

Individuals who engage in negotiation, working to reach an agreement or resolve a dispute.