WBR0373
| Author | [[PageAuthor::Rim Halaby, M.D. [1]]] |
|---|---|
| Exam Type | ExamType::USMLE Step 1 |
| Main Category | MainCategory::Embryology |
| Sub Category | SubCategory::Renal |
| Prompt | [[Prompt::A 27 year old pregnant gravida 1 para 0 presents to the emergency department at 18 weeks gestation with rupture of membranes. Upon questioning, she did not receive any prenatal care and was not followed by an obstetrician. Following appropriate intervention, the patient’s fetus is evacuated but is not viable. Inspection of the fetus reveals clubbed feet and cranial anomalies. Which of the following additional findings is also expected to be most likely present on autopsy?]] |
| Answer A | AnswerA::Horseshoe kidney |
| Answer A Explanation | AnswerAExp::Horseshoe kidney is caused by the fusion of the inferior poles of both kidneys. It is not associated with Potter’s syndrome. |
| Answer B | AnswerB::Ventricular septal defect (VSD) |
| Answer B Explanation | AnswerBExp::VSD is a the most common congenital heart defect. However, it is not directly associated with Potter’s syndrome. |
| Answer C | AnswerC::Renal agenesis |
| Answer C Explanation | AnswerCExp::Oligohydramnios, commonly associated with bilateral renal agenesis, can give rise to Potter’s syndrome. |
| Answer D | AnswerD::Thymic aplasia |
| Answer D Explanation | AnswerDExp::Thymic aplasia is a characteristic finding in DiGeorge syndrome, a congenital disorder due to 22q11 deletion. DiGeorge syndrome is characterized by congenital heart disease, abnormal facies, thymic aplasia, cleft palate, and hypocalcemia. |
| Answer E | AnswerE::Mandibular hypoplasia |
| Answer E Explanation | AnswerEExp::Mandibular hypoplasia is a manifestation of Treacher-Collins syndrome. It is caused by failure of neural crest migration of the first branchial arch. |
| Right Answer | RightAnswer::C |
| Explanation | [[Explanation::Potter’s Syndrome is a triad of clubbed feet, pulmonary hypoplasia, and cranial anomalies. Oligohydramnios, commonly associated with bilateral renal agenesis, can give rise to Potter’s syndrome. Other causes of oligohydramnios include ureteral or urethral atresia, polycystic kidney disease, renal hypoplasia, and uteroplacental insufficiency.
The incidence of Potter’s syndrome is related to the degree of oligohydramnios and to the gestational age at which rupture takes place. Approximately 50% of infants with rupture at 19 weeks’ gestation or earlier are affected with Potter’s syndrome. |
| Approved | Approved::No |
| Keyword | |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |