What are common signs associated with Down Syndrome?

A. Tuberculosis:

TB is a lung infection, not commonly associated with secondary hypertension.

B. Endocarditis:

Endocarditis is an infection of the heart valves, leading to emboli and heart failure but not directly causing hypertension.

C. Obstructive sleep apnea:

OSA can cause secondary hypertension due to intermittent hypoxia and sympathetic nervous system activation during sleep.

D. Polycythemia:

Polycythemia increases blood viscosity, which can lead to increased blood pressure, but it's a less common cause than conditions like OSA, renal disease, or endocrine disorders for secondary hypertension.

A. A callus that forms on an ossicle:

No callus forms on the ossicles with cerumen impaction. Ossicle problems (like otosclerosis) involve bone remodeling, not wax.

B. Inflammation of the innermost part of the ear:

This describes labyrinthitis or inner ear infections, not cerumen impaction.

C. Blockage of the ear canal due to built-up ear wax:

Cerumen impaction is the accumulation of earwax blocking the external ear canal, leading to symptoms like hearing loss or fullness.

D. Accumulation of skin cells behind the tympanic membrane or within the mastoid bone:

This describes a cholesteatoma, not cerumen impaction.