Approach to prenatal teratogen exposure Quiz: Ace Your Exams
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A 3-year-old boy is brought to the clinic for a well child visit. The patient was born at full term, and immunizations are up to date. Maternal history includes seizures (controlled with medication), alcohol intake, and cigarette smoking. The parent reports the child has always been healthy, though a bit small for age. Compared to siblings, development is mildly delayed, and the patient has a poor attention span. Weight and height are at the 5th and 10th percentiles for age, respectively. Temperature is 37°C (98.6°F), pulse is 97/min, respirations are 20/min, blood pressure is 95/51 mmHg, and oxygen saturation is 99% on room air. On physical examination, short palpebral fissures, a thin vermilion border, and a smooth philtrum are noted. A loud, harsh, holosystolic murmur is heard at the lower left sternal border. Prenatal exposure to which of the following best explains the findings?
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