A 15-year-old Ashkenazi Jewish girl is seen because of chronic fatigue. On examination, she seems pale and thin and has a somewhat large abdomen. Her spleen is felt in the iliac fossa. She is mentally alert and has a history of normal development and normal school performance. Her blood count shows hemoglobin of 9.0 g/dL and a white blood cell count of 3000 with normal differential and no abnormal cells. Platelet count is 60,000. The likely diagnosis is

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Pediatric Endocrine Exam Questions Questions

Question 1 of 5

A 15-year-old Ashkenazi Jewish girl is seen because of chronic fatigue. On examination, she seems pale and thin and has a somewhat large abdomen. Her spleen is felt in the iliac fossa. She is mentally alert and has a history of normal development and normal school performance. Her blood count shows hemoglobin of 9.0 g/dL and a white blood cell count of 3000 with normal differential and no abnormal cells. Platelet count is 60,000. The likely diagnosis is

Correct Answer: C

Rationale: Gaucher type I, common in Ashkenazi Jews, presents with splenomegaly, anemia, and thrombocytopenia without neurologic involvement.

Question 2 of 5

A 7-month-old white female presents with severe developmental delay and episodes of vomiting. Physical examination reveals blue eyes, light skin with an eczematoid rash, and hyperactive deep tendon reflexes. There is failure to thrive and microcephaly. The most likely diagnosis is

Correct Answer: D

Rationale: Phenylketonuria (PKU) causes developmental delay, microcephaly, rash, and light pigmentation if untreated.

Question 3 of 5

Complications of tyrosinemia include all of the following EXCEPT

Correct Answer: A

Rationale: Cataracts are not a feature of tyrosinemia; others (renal, liver, nerve issues) are common.

Question 4 of 5

Matching: Giant granules in granulocytes

Correct Answer: A

Rationale: Chédiak-Higashi syndrome features giant granules in neutrophils.

Question 5 of 5

The plasma amino acids in the patient in the previous two questions reveal a marked elevation of leucine, isoleucine, and valine. The most likely diagnosis is

Correct Answer: A

Rationale: Maple syrup urine disease (MSUD) causes elevated branched-chain amino acids (leucine, isoleucine, valine).

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