Which of the following is an abnormal finding in a male child? ...

[jon_i]

Which of the following is an abnormal finding in a male child?
 
  A. Gynecomastia during puberty
  B. Undescended testicles at 3 months
  C. Enlarged scrotum during infancy
  D. None of the above

Question 2

It is important for the clinician to recognize that a patent ductus arteriosus, which directs the fetal bloodstream from pulmonary artery to aorta, does not close until:
 
  A. Day 4 after birth
  B. 1 week after birth
  C. 2 weeks after birth
  D. 1 month after birth

[aloop]

Answer to Question 1

ANS: D
Observe the location of the urethral meatus. Hypospadias is a congenital defect that causes the meatus to be on the ventral surface of the penis, and epispadias results in dorsal placement of the meatus. Palpate the scrotum for the presence of testes; cryptorchidism is the term for an undescended testicle. If the testes are not immediately palpable in the scrotum but can be milked down into the scrotum, consider them descended. If one or both testes are undescended at 1 year of age, referral to a specialist is indicated. Male newborns frequently have an enlarged scrotum as a normal finding. Gynecomastia may be normal in males during puberty. It usually occurs during Tanner stages II and III and may last up to 2 years. Gynecomastia typically presents as a small, tender oval mass directly under the areola that may measure up to 2 to 3 cm.

Answer to Question 2

ANS: A
In newborns, innocent murmurs are common and are usually systolic, grade I or II, and are not associated with other symptoms. The transition period from fetal to maternal conditions may take 48 hours. Patent ductus arteriosus is a fetal vascular connection that directs blood from the pulmonary artery to the aorta. It typically closes by day 4 following birth. However, if it remains patent, the direction of blood flow is reversed through the ductus, owing to the higher pressure in the aorta. Clinical findings in a newborn with a still-patent ductus arteriosus include diaphoresis (especially during feedings) and poor feedings with easy tiring that may result in failure to thrive.