USMLE Forum Archives - USMLE Step 2 CK - peds
peds
Sarahhh - 02-03-08 20:48
A 14-yr-old boy is evaluated for short stature. He has no significant past medical
history and is considered healthy otherwise by his parents. He eats a normal diet and
takes regular meals. His height and weight have been consistently below the fifth
percentile since childhood. His physical examination is normal with genitilia at tanner
stage 3. Which of the following is most likely abnormal laboratory finding for this boy.
A. Bone age that is equivalent to chronologic age.
B. Decreased complement C3 levels.
C. Decreased serum albumin concentration.
D. Decreased TSH concentration.
E. Decreased serum creatinine concentration
Sarahhh - 02-03-08 20:48
A 14-yr-old boy is evaluated for short stature. He has no significant past medical
history and is considered healthy otherwise by his parents. He eats a normal diet and
takes regular meals. His height and weight have been consistently below the fifth
percentile since childhood. His physical examination is normal with genitilia at tanner
stage 3. Which of the following is most likely abnormal laboratory finding for this boy.
A. Bone age that is equivalent to chronologic age.
B. Decreased complement C3 levels.
C. Decreased serum albumin concentration.
D. Decreased TSH concentration.
E. Decreased serum creatinine concentration
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#3
Re: peds
Sarahhh - 02-05-08 08:00 A. This boy most likely has familial short stature (FSS). Children
with FSS usually have a normal birth weight and length. At the age of 2-3 years,
however, their growth begins to decelerate and drops to around the 5th percentile. The
onset and progression of puberty in children with FSS are normal. Bone age is typically
consistent with the chronologic age.
A decreased complement C3 level (choice B) may suggest chronic inflammatory
disorders. But, the lack of any signs or symptoms makes any chronic inflammatory
disorder unlikely.
A decreased serum albumin concentration (choice C) can be secondary to a variety of
conditions, such as nephrotic syndrome and malnutrition. But, the lack of supportive
history and physical examination data makes these conditions unlikely.
Decreased thyroid stimulating hormone (choice D) suggests hyperthyroidism as the
etiology of the boy's short stature, but it is highly unlikely in this case.
An increased serum creatinine level (choice E) indicates renal failure, but this is
inconsistent with the child's history and physical examination.
#7
Re: peds bingousmle - 06-30-10 12:18 A....the boy has a constitutional delay in achieving the desired height for age.. because his history shows normal sexual development which is consistent with his age
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