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  #1  
Old 06-14-2012
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Pediatrics Neonatal Tetany and Boutes of Pneumonia!

A 30-year-old woman gives birth at term to a normal appearing infant girl. One hour after birth, the neonate exhibits tetany. On physical examination, she is at 55th percentile for height and weight. Laboratory studies show serum calcium of 6.3 mg/dl and phosphorus of 3.5 mg/dl. Over the next year, the infant has bouts of pneumonia caused by Pneumocystis jirovenci and spergillus fumigatus and upper respiratory tract infections with parainfluenza virus and herpes simplex virus. Which of the following mechanisms is most likely to be responsible for the development of the clinical features seen in this infant?
A) Malformation of the third and fourth pharyngeal pouches
B) Failure of maturation of B cells into plasma cells
C) Lack of adenosine deaminase
D) Acquisition of maternal HIV infection at delivery
E) Failure of differentiation of pre-B cells into B cells

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  #2  
Old 06-15-2012
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Could it be A? Digeorge? Would explain the hypocalcemia (Absence of parathyroid), and the pneumocystis & viral infections (absence of mature T cells as there's no Thymus.)
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Old 06-15-2012
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Yeah I'd go with A as well. Looks like DiGeorge Syndrome.
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Old 06-15-2012
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I would choose A (Di George Syndrome)
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Old 06-15-2012
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The defect is in the third and the fourth pharyngeal pouches and other clues include thymic hypoplasia, hypoparathyroidism, and recurrent infections. So I would say Di George syndrome is the answer.
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Old 06-15-2012
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Obviously no doubt that the answer is option (A) i.e. Di George syndrome.
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Old 06-15-2012
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Yeah definitely A but be careful on the exam guys...SCID can also show up with thymus aplasia...virus +fungi=di George's....virus fungi + bacteria and Protozoa = SCID
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  #8  
Old 06-15-2012
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A diGeorge...
__________________
I am not 'THE BEST', but I am not like 'THE REST'..
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Old 06-15-2012
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@casandra
hope these questions are not from nbme?????
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Old 06-15-2012
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Quote:
Originally Posted by imgchuchu View Post
@casandra
hope these questions are not from nbme?????
I think she said their from Robbins and Cotrans book
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Old 06-16-2012
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Default correct answer :)

Correct answer is A) Malformation of the third and fourth pharyngeal pouches
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Old 06-16-2012
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Quote:
Originally Posted by imgchuchu View Post
@casandra
hope these questions are not from nbme?????
Of course not. It's from Robbins.
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Immunology-, Pathology-, Pediatrics-, Step-1-Questions, Syndromes-Acronyms

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