A 3-year-old girl has a presentation that meets criteria for autism spectrum disorder. However, a careful history identifies that her head growth began to decelerate around 8 months. What diagnosis will she receive?
Autism spectrum disorder
Rett syndrome
Global developmental delay
Pervasive developmental delay
The Correct Answer is B
Choice A reason: Autism spectrum disorder involves social communication deficits and restricted/repetitive behaviors, but does not typically include deceleration of head growth after normal early development.
Choice B reason: This is correct. Rett syndrome, primarily affecting females, is characterized by normal early development followed by regression, deceleration of head growth (microcephaly), loss of purposeful hand skills, and social and motor impairments. The head growth deceleration at 8 months supports Rett syndrome over ASD.
Choice C reason: Global developmental delay is a diagnosis for children under 5 with delays in multiple developmental domains but does not explain the specific pattern of regression and head growth deceleration seen here.
Choice D reason: Pervasive developmental disorder is an outdated term encompassing ASD and similar conditions; it would not capture the distinctive features of Rett syndrome in this scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Tourette’s syndrome involves chronic motor and vocal tics with onset typically before age 18, but it is not associated with sudden onset triggered by infection.
Choice B reason: This is correct. PANDAS is characterized by the sudden onset of OCD and/or tics following a streptococcal infection, consistent with this child’s acute symptom onset.
Choice C reason: Obsessive-compulsive disorder may present with gradual onset rather than abrupt onset after infection, making PANDAS a more accurate diagnosis in this scenario.
Choice D reason: Neurodevelopmental disorders are typically chronic, pervasive conditions beginning early in development, not acute, post-infectious symptom clusters.
Correct Answer is C
Explanation
Choice A reason: SSRIs are not indicated for cluster headaches. These medications are primarily used to treat depression and anxiety and have minimal effect on the pathophysiology of cluster headaches.
Choice B reason: Diazepam, a benzodiazepine, may help with anxiety or insomnia but is not effective in aborting or preventing cluster headaches.
Choice C reason: This is the correct answer. Cluster headaches are severe, unilateral, stabbing headaches often associated with autonomic symptoms like tearing and nasal congestion. Sumatriptan, a selective serotonin 5-HT1B/1D receptor agonist, is the treatment of choice for acute attacks due to its rapid onset and ability to alleviate pain.
Choice D reason: Naproxen, an NSAID, may be effective for tension-type headaches or migraine prophylaxis but is ineffective for acute cluster headache attacks due to the extreme severity and rapid onset of pain.
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