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AVYity TVI watch Full Free Mcwx Couch Tuner Tw videos FREE: Curry FACUTYSTAFF x Take Test: Individual Project Chegg Study I Guided Solut C secure https: bbhosted cuny.edu 356331-1&content; id L28173245 1&step; nu Question C ompletion Status: QUESTION 1 00 points Save Answer Chad, a two-year-old boy who has come for well child care. At Chad's last well child visit, at 5 months of age, the history and physical examination were normal, but he was not talking Chad still has no expressive language. He appears to hear normally and follows simple commands. His gross and fine motor development appear normal for his age. He is described as shy. Parents note that he is not communicative with other children or adults and consistently avoid eye contact. uently irritable and hyperactive at home. Neonatal history Chad s kg product of a normal pregnancy and delivery His mother had no history of prenatal bstance abuse, Chad was born with vaginal was the 3,5 illness, medication use, alcohol use, or su delivery without any complications and he was normal during newbom ion Family history. Chad has a healthy four-year-old sister, Kara. Kara is also shy but has been doing well in day care. Kara began to use single words at about 15 months of age and has no evidence of developmental problems. Chad's father, Jack, is healthy. His mother, Monica, is 26 years old and in good general health. Monica is the youngest of three ren. Her older brother was "slow in school. He was killed in a motor vehicle accident when Monica was a teenager. Her sister left home at 16 years of age and has since had only intermittent contact with Monica. She is healthy and married but has no chil dren to Monica's knowledge. Monica's parents are reasonable health; at age 66 her father has hypertension and degenerative oint disease and at age 60, her mother has diet-controlled diabetes mel Social history. Monica works in environmental services at a downtown office building. She struggled academically in school, attaining only a 10th grade education. Jack works as a backhoe operator in a local construction company. He also struggled in school but graduated from hi gh school. Monica and Jack are happily married and there is no history of alcohol or substance abuse or domestic violence. The family's health insuran ce is provided by Medicaid, although Jack will soon be eligible for coverage through his employer. Physical examination. Chad is at the lower height and weight developmental milestone, and has a normal head size for his age. These thdrawn and resists being examined. Except for otitis media, measures are consistent with previous points on the growth chart. While sitting on his mothers lap, he is wi his physical examination is normal Physical exam: A developmentally delayed boy with elongated face, large ear and appears withdrawn Respiratory rate: 18 breaths per minute inormal 12-20 xy minute) Blood pressure: 100/80 mmHg (norm 20/B0 mmHl Heart rate: 94 beats per minute (no rmal 60-100 x/minute) Lung: clear to auscultation. perature: 379C. (no mal: 36. -37.2 EliseeExplanation / Answer
Chief complaint : delayed development and withdrawn appearance.
History of illness : Normally delivered child with no past illnesses.
Family history : An uncle who was considered to be slow and grandmother having diet controlled diabetes mellitus.
Possible diagnosis :
- Fragile X syndrome
- Autism
- DSM-IV-TR : communication disorders
Pathophysiology :
1. Fragile X syndrome - The child is having long face along with reduced communication skills. The child is hyperactive with no social interactions as of now and this is more common in males. The Fragile X syndrome is a genetic disorder showing mild to moderate intellectual disability. Hyperactivity is a common symptom along and also seizures.
2. Autism: Charachterised by delayed social skills and slow learning abilities . Also, there is an impaired verbal and non verbal communication . Symptoms become evident by the age of three. The child is having long face along with reduced communication skills. The child is hyperactive with no social interactions as of now.
3. Communication disorders : Slow learning along with expressive language disorders.
Additional tests :
- genetic testing by determining number of CGG repeats in FMRI gene for determining Fragile X syndrome.
- Autism can be tested by physical examinations and metabolic and neuroimaging tests.
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