Congenital rubella syndrome

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Congenital rubella syndrome

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USMLE® Step 1 style questions USMLE

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A 1 month-old girl is brought to the clinic for a routine evaluation. The patient was delivered via a cesarean at 38-weeks gestational age due to arrested labor. The mother immigrated from Zambia ten months ago and received minimal prenatal care. During the first trimester of pregnancy, she developed an upper respiratory infection and self-limited joint pain affecting the wrists, knees, and ankles. Family history is notable for retinitis pigmentosa. The patient’s weight is at the 20th percentile, and head circumference is at the 50th percentile. Vitals are within normal limits. She does not move her head in response to sounds. Facial features appear normal. Physical examination is notable for petechiae and purpura over the arms, trunk, and legs. A cardiac examination reveals a continuous murmur heard in the left infraclavicular area. Abdominal examination is notable for hepatosplenomegaly. Which of the following findings is most likely present on this patient’s ophthalmologic examination?  

External References

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Atrial septal defect (ASD) p. 303

congenital rubella p. 304

Congenital rubella

cardiac defect associations p. 304

heart murmur p. 296

Patent ductus arteriosus (PDA)

congenital rubella p. 304

Ventricular septal defect (VSD) p. 303, 731

congenital rubella p. 304

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Summary

Congenital rubella syndrome (CRS) is a group of birth defects that can occur in a baby infected with the rubella virus during pregnancy. It generally results from an intrauterine mother-to-fetus transmission of the virus. It is characterized by a triad of symptoms: sensorineural hearing loss, cataracts, and heart defects. Other associated symptoms include glaucoma (increased pressure inside the eyes), mental retardation, cerebral palsy, and joint deformities.