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Ochuko Ajari (talk | contribs) (Created page with "{{WBRQuestion |QuestionAuthor={{Ochuko}} |ExamType=USMLE Step 1 |MainCategory=Genetics, Pathophysiology |SubCategory=Vascular |MainCategory=Genetics, Pathophysiology |SubCateg...") |
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|Prompt=A 15- year old female is brought to the physician’s office by the mother for complaints of abdominal pain. There is no history of trauma to any part of the body. Physical examination reveals delayed femoral pulses with respect to the brachial pulses and pulsatile vessels along the axilla and the ribs. The patient’s condition is likely to be seen with which one of the following? | |Prompt=A 15- year old female is brought to the physician’s office by the mother for complaints of abdominal pain. There is no history of trauma to any part of the body. Physical examination reveals delayed femoral pulses with respect to the brachial pulses and pulsatile vessels along the axilla and the ribs. The patient’s condition is likely to be seen with which one of the following? | ||
|Explanation=Diminished femoral pulses compared to the brachial pulses, pulsatile vessels along axilla and ribs in a young child/adult are characteristics of adult type congenital coarctation of the aorta. Turner syndrome (an XO sex chromosome disorder) is associated with coarctation of the aorta in females. | |Explanation=Diminished femoral pulses compared to the brachial pulses, pulsatile vessels along axilla and ribs in a young child/adult are characteristics of adult type congenital coarctation of the aorta. Turner syndrome (an XO sex chromosome disorder) is associated with coarctation of the aorta in females. | ||
|AnswerA=[[Marfan syndrome]] | |AnswerA=[[Marfan syndrome]] | ||
|AnswerAExp=Incorrect. Marfan syndrome is associated with [[aortic dissection|dissecting aortic aneurysms]] and [[aortic insufficiency|aortic valve incompetence]]. There may also be an associated [[mitral valve prolapse]] | |AnswerAExp=Incorrect. Marfan syndrome is associated with [[aortic dissection|dissecting aortic aneurysms]] and [[aortic insufficiency|aortic valve incompetence]]. There may also be an associated [[mitral valve prolapse]] | ||
|AnswerB=[[Down syndrome]] | |AnswerB=[[Down syndrome]] | ||
|AnswerBExp=Incorrect. Down syndrome is associated with [[endocardial cushion defect]]s that results in [[atrial septal defect]] and [[aortic valve regurgitation]] | |AnswerBExp=Incorrect. Down syndrome is associated with [[endocardial cushion defect]]s that results in [[atrial septal defect]] and [[aortic valve regurgitation]] | ||
|AnswerC=[[Turner syndrome]] | |AnswerC=[[Turner syndrome]] | ||
|AnswerCExp=Correct. See Explanation | |AnswerCExp=Correct. See Explanation | ||
|AnswerD=[[ | |AnswerD=[[Friedreich's ataxia]] | ||
|AnswerDExp=Incorrect. Friedreich’s ataxia is associated with [[hypertrophic cardiomyopathy]] and the femoral pulses are not affected in this case | |AnswerDExp=Incorrect. Friedreich’s ataxia is associated with [[hypertrophic cardiomyopathy]] and the femoral pulses are not affected in this case | ||
|AnswerE=[[Kartagener syndrome]] | |AnswerE=[[Kartagener syndrome]] | ||
Revision as of 16:43, 8 October 2013
| 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 female is brought to the physician’s office by the mother for complaints of abdominal pain. There is no history of trauma to any part of the body. Physical examination reveals delayed femoral pulses with respect to the brachial pulses and pulsatile vessels along the axilla and the ribs. The patient’s condition is likely to be seen with which one of the following?]] |
| Answer A | [[AnswerA::Marfan syndrome]] |
| Answer A Explanation | [[AnswerAExp::Incorrect. Marfan syndrome is associated with dissecting aortic aneurysms and aortic valve incompetence. There may also be an associated mitral valve prolapse]] |
| Answer B | [[AnswerB::Down syndrome]] |
| Answer B Explanation | [[AnswerBExp::Incorrect. Down syndrome is associated with endocardial cushion defects that results in atrial septal defect and aortic valve regurgitation]] |
| Answer C | [[AnswerC::Turner syndrome]] |
| Answer C Explanation | AnswerCExp::Correct. See Explanation |
| Answer D | [[AnswerD::Friedreich's ataxia]] |
| Answer D Explanation | [[AnswerDExp::Incorrect. Friedreich’s ataxia is associated with hypertrophic cardiomyopathy and the femoral pulses are not affected in this case]] |
| Answer E | [[AnswerE::Kartagener syndrome]] |
| Answer E Explanation | [[AnswerEExp::Incorrect. Kartagener syndrome is due to a microtubulular dynein arm defect and is associated with situs invertus and not aortic coarctation. Infertility, recurrent sinusitis and bronchiectasis result]] |
| Right Answer | RightAnswer::C |
| Explanation | [[Explanation::Diminished femoral pulses compared to the brachial pulses, pulsatile vessels along axilla and ribs in a young child/adult are characteristics of adult type congenital coarctation of the aorta. Turner syndrome (an XO sex chromosome disorder) is associated with coarctation of the aorta in females. Educational Objective: |
| Approved | Approved::Yes |
| Keyword | WBRKeyword::Delayed femoral pulses, WBRKeyword::brachial pulse, WBRKeyword::pulsatile vessels, WBRKeyword::pulsation |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |