USMLE Question of the Week

Evaluating Cardiovascular Congenital Abnormalities in a Newborn

In Episode 50 of Med School Question of the Week for USMLE, Faustine Ramirez, MedSchoolCoach expert tutor, answers this medical school question:

A 2-week-old male newborn is brought to the pediatrician’s office by his parents for a routine visit. He was born at term to a 37-year-old woman who received good prenatal care. He has been feeding every 2-3 hours and having 5-6 wet diapers a day. Weight is in the 8th percentile, length in the 12th percentile, and head circumference in the 5th percentile. On examination, he has a flat nasal bridge, widely spaced upslanting eyes, low-set ears, and a large protruding tongue. Light grey spots are observed on both irises. A small, reducible umbilical hernia is present, along with a single palmar crease, and mild axial hypotonia. Which of the following is the most likely finding on cardiovascular examination?

  • Continuous machine-like murmur
  • Single S2
  • Fixed wide splitting of S2
  • Bounding pulses
  • Upper and lower extremity BP differential
  • Single S2 and crescendo-decrescendo systolic ejection murmur at LUSB
  • Fixed wide splitting of S2 and systolic ejection murmur at LUSB

Watch to find out!

Faustine Ramirez

Faustine graduated from the University of Washington in Seattle with a B.A. in Medical Anthropology and Global Health. She attends medical school at University of California, San Francisco where she designed and taught a course on clinical reasoning skills, developed curriculum materials for the pre-clinical pediatrics course, and led case-based sessions in pediatrics and infectious disease. She received a 253 on Step 1 and a 266 on Step 2 CK, and she scored in the 90th percentiles on all of her shelf exams.

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