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|MainCategory=Genetics, Pathophysiology
|MainCategory=Genetics, Pathophysiology
|SubCategory=Vascular
|SubCategory=Vascular
|MainCategory=Genetics, Pathophysiology
|MainCategory=Genetics, Pathophysiology
|MainCategory=Genetics, Pathophysiology
|MainCategory=Genetics, Pathophysiology
|MainCategory=Genetics, Pathophysiology
Line 21: Line 22:
|SubCategory=Vascular
|SubCategory=Vascular
|Prompt=A 15-year-old presents to the physician’s office for complaints of abdominal pain. There is no history of trauma to any part of her body. Physical examination reveals delayed femoral pulses, with respect to the brachial pulses and pulsatile vessels, along the axilla and the ribs. Which of the following conditions is the most likely diagnosis for the patient?
|Prompt=A 15-year-old presents to the physician’s office for complaints of abdominal pain. There is no history of trauma to any part of her body. Physical examination reveals delayed femoral pulses, with respect to the brachial pulses and pulsatile vessels, along the axilla and the ribs. Which of the following conditions is the most likely diagnosis for the patient?
|Explanation= Delayed femoral pulses, with respect to the brachial pulses and pulsatile vessels, along the axilla and the ribs of a young patient, are characteristic of an adult type congenital coarctation of the aorta. Turner syndrome, an XO sex-chromosome abnormality resulting from nondisjunction in the sperm cells, is associated with coarctation of the aorta.
|Explanation=Delayed femoral pulses, with respect to the brachial pulses and pulsatile vessels, along the axilla and the ribs of a young patient, are characteristic of an adult type congenital coarctation of the aorta. Turner syndrome, an XO sex-chromosome abnormality resulting from nondisjunction in the sperm cells, is associated with coarctation of the aorta.
 
|AnswerA=Marfan syndrome
|EducationalObjectives= Delayed femoral pulses, with respect to the brachial pulses and pulsatile vessels, along the axilla and the ribs of a young patient, are characteristic of an adult type congenital coarctation of the aorta. Turner syndrome, an XO sex-chromosome abnormality resulting from nondisjunction in the sperm cells, is associated with coarctation of the aorta.
|AnswerAExp=[[Marfan syndrome]] is often associated with [[aortic dissection|dissecting aortic aneurysms]] and [[aortic insufficiency|aortic valve incompetence]]. [[Marfan syndrome]] may also be associated with [[mitral valve prolapse]].
|References=
|AnswerB=Down syndrome
 
|AnswerBExp=[[Down syndrome]] is often associated with [[endocardial cushion defect]]s, which results in [[atrial septal defect]] and [[aortic valve regurgitation]].
|AnswerA=[[Marfan syndrome]]
|AnswerC=Turner syndrome
|AnswerAExp= [[Marfan syndrome]] is often associated with [[aortic dissection|dissecting aortic aneurysms]] and [[aortic insufficiency|aortic valve incompetence]]. [[Marfan syndrome]] may also be associated with [[mitral valve prolapse]].
|AnswerCExp=See Explanation.
|AnswerB=[[Down syndrome]]
|AnswerD=Friedreich's ataxia
|AnswerBExp= [[Down syndrome]] is often associated with [[endocardial cushion defect]]s, which results in [[atrial septal defect]] and [[aortic valve regurgitation]].
|AnswerDExp=[[Friedreich’s ataxia]], often associated with [[hypertrophic cardiomyopathy]], does not impact the femoral pulses.
|AnswerC=[[Turner syndrome]]
|AnswerE=Kartagener syndrome
|AnswerCExp= See Explanation.
|AnswerEExp=[[Kartagener syndrome]], due to a microtubulular [[dynein]] arm defect, is associated with [[situs inversus]], but not [[aortic coarctation]]. [[Kartagener syndrome]] often results in [[infertility]], [[sinusitis|recurrent sinusitis]], and [[bronchiectasis]].
|AnswerD=[[Friedreich's ataxia]]
|EducationalObjectives=Delayed femoral pulses, with respect to the brachial pulses and pulsatile vessels, along the axilla and the ribs of a young patient, are characteristic of an adult type congenital coarctation of the aorta. Turner syndrome, an XO sex-chromosome abnormality resulting from nondisjunction in the sperm cells, is associated with coarctation of the aorta.
|AnswerDExp= [[Friedreich’s ataxia]], often associated with [[hypertrophic cardiomyopathy]], does not impact the femoral pulses.
|References=First Aid 2014 page 283 (coarctation of the aorta) ; 574 (Turner Syndrome)
|AnswerE=[[Kartagener syndrome]]
|AnswerEExp= [[Kartagener syndrome]], due to a microtubulular [[dynein]] arm defect, is associated with [[situs inversus]], but not [[aortic coarctation]]. [[Kartagener syndrome]] often results in [[infertility]], [[sinusitis|recurrent sinusitis]], and [[bronchiectasis]].
|RightAnswer=C
|RightAnswer=C
|WBRKeyword=Delayed femoral pulses, brachial pulse, Pulsatile vessels
|WBRKeyword=Delayed femoral pulses, brachial pulse, Pulsatile vessels
|Approved=Yes
|Approved=Yes
}}
}}

Revision as of 18:02, 31 August 2014
Author [[PageAuthor::Ogheneochuko Ajari, MB.BS, MS [1]]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Genetics, MainCategory::Pathophysiology
Sub Category SubCategory::Vascular
Prompt [[Prompt::A 15-year-old presents to the physician’s office for complaints of abdominal pain. There is no history of trauma to any part of her body. Physical examination reveals delayed femoral pulses, with respect to the brachial pulses and pulsatile vessels, along the axilla and the ribs. Which of the following conditions is the most likely diagnosis for the patient?]]
Answer A AnswerA::Marfan syndrome
Answer A Explanation [[AnswerAExp::Marfan syndrome is often associated with dissecting aortic aneurysms and aortic valve incompetence. Marfan syndrome may also be associated with mitral valve prolapse.]]
Answer B AnswerB::Down syndrome
Answer B Explanation [[AnswerBExp::Down syndrome is often associated with endocardial cushion defects, which results in atrial septal defect and aortic valve regurgitation.]]
Answer C AnswerC::Turner syndrome
Answer C Explanation AnswerCExp::See Explanation.
Answer D AnswerD::Friedreich's ataxia
Answer D Explanation [[AnswerDExp::Friedreich’s ataxia, often associated with hypertrophic cardiomyopathy, does not impact the femoral pulses.]]
Answer E AnswerE::Kartagener syndrome
Answer E Explanation [[AnswerEExp::Kartagener syndrome, due to a microtubulular dynein arm defect, is associated with situs inversus, but not aortic coarctation. Kartagener syndrome often results in infertility, recurrent sinusitis, and bronchiectasis.]]
Right Answer RightAnswer::C
Explanation [[Explanation::Delayed femoral pulses, with respect to the brachial pulses and pulsatile vessels, along the axilla and the ribs of a young patient, are characteristic of an adult type congenital coarctation of the aorta. Turner syndrome, an XO sex-chromosome abnormality resulting from nondisjunction in the sperm cells, is associated with coarctation of the aorta.

Educational Objective: Delayed femoral pulses, with respect to the brachial pulses and pulsatile vessels, along the axilla and the ribs of a young patient, are characteristic of an adult type congenital coarctation of the aorta. Turner syndrome, an XO sex-chromosome abnormality resulting from nondisjunction in the sperm cells, is associated with coarctation of the aorta.
References: First Aid 2014 page 283 (coarctation of the aorta) ; 574 (Turner Syndrome)]]

Approved Approved::Yes
Keyword WBRKeyword::Delayed femoral pulses, WBRKeyword::brachial pulse, WBRKeyword::Pulsatile vessels
Linked Question Linked::
Order in Linked Questions LinkedOrder::
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