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The medial crease of the foot is accentuated. The foot has almost no flexibility. You diagnose a unilateral rigid club foot deformity. Which statement is NOT true? , spina bifida, neuromuscular deformity c) This deformity usually prevents a child from standing and walking d) After surgery, long-term observation and bracing is usually necessary e) These children are active and participate with peers in the usual physical activities The Correct answer is C Explanation Most of these children are healthy infants with a clubfoot of unknown cause and will crawl, stand, and walk.

Patients with innocent heart murmurs should be free of such symptoms or signs. Murmurs which are attenuated with changing body position are usually innocent. Therefore, when history is obtained and during physical examination symptoms and signs which may point to heart disease should be identified. The presence of symptoms and/or signs of heart disease will suggest the pathological nature of the heart murmur being investigated. Abnormal findings indicating a pathological origin of a heart murmur include: shortness of breath, easy fatigue, failure to thrive, cyanosis.

Therefore, the pH will be low or normal (due to compensation). The HCO3 will be low (due to metabolic acidosis) and the pCO2 will be low (due to respiratory compensation). During a health maintenance examination, a 14 year old black male is noted to have asymmetric breast enlargement with mild tenderness. The remainder of the physical examination is normal. The most appropriate management in this case is to a) Reassure the patient and have him return in 6 months b) Order a chest radiograph c) Order serum estrogen and testosterone levels d) Order chromosomal studies e) Arrange for a biopsy The Correct answer is A Explanation Some gynecomastia occurs in 30%-50% of pubertal males.

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