WBR0102

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Author PageAuthor::William J Gibson
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Genetics
Sub Category SubCategory::Cardiology, SubCategory::Musculoskeletal/Rheumatology
Prompt [[Prompt::A 10 year old girl is taken into the custody of child protective services after her teacher notices that she has had the consistent appearance of new bruises for the second month in a row. She is brought to a pediatrician for medical examination. The pediatrican collects a thorough history during which the girl insists that her parents have not harmed her, she just “plays rough”. Further questioning reveals that the girl would like to perform in a circus, because she is unusually flexible and can contort her limbs in ways her peers cannot. Physical exam is remarkable for hyperextensible skin. The physican reassures the girl and advises child protective services that the child may return to her parents. Which of the following is most true of the child’s condition?]]
Answer A AnswerA::Caused by defects in fibrillin.
Answer A Explanation AnswerAExp::Incorrect - this is true of Marfan syndrome.
Answer B AnswerB::Caused by defects in hydroxylation of proline residues
Answer B Explanation AnswerBExp::Incorrect - this is true of scurvy, or vitamin C deficiency
Answer C AnswerC::Caused by defects in Type I Collagen
Answer C Explanation AnswerCExp::Incorrect - While the Arthrochalasia subtype of Ehlers Danlos syndrome can be caused by defects in Type I Collagen, only 30 cases have been reported. Defects in Type I Collagen much more commonly cause Osteogenesis Imperfecta.
Answer D AnswerD::Associated with nephritis
Answer D Explanation AnswerDExp::Incorrect - This is true of Alport Syndrome.
Answer E AnswerE::Associated with formation of berry aneurysms
Answer E Explanation AnswerEExp::Correct - See explanation.
Right Answer RightAnswer::E
Explanation [[Explanation::The child in this vignette is suffering from Ehlers-Danlos syndrome.

References: First Aid 2012 page 83.
Educational Objective:
References: ]]

Approved Approved::Yes
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