Family Nurse Practitioner Exam

What condition is most likely for a newborn with shortened palpebral fissures and microcephaly?

1. Down syndrome

2. Fetal alcohol syndrome

3. Growth retardation

4. Hydrocephalus

The correct answer is: Fetal alcohol syndrome

The presentation of shortened palpebral fissures and microcephaly in a newborn is most indicative of fetal alcohol syndrome (FAS). This condition arises from prenatal exposure to alcohol, leading to a range of physical and neurodevelopmental defects. Shortened palpebral fissures are a classic facial feature associated with FAS, along with other characteristic traits that can include a flat midface and thin upper lip. Microcephaly, or a smaller than normal head circumference, is also frequently observed in infants affected by this syndrome, reflecting potential underlying brain damage due to alcohol exposure during critical periods of development. Other conditions listed do not specifically align with the combination of features presented. For instance, Down syndrome is characterized by distinct facial features and extra chromosome 21 associated anomalies, but shortened palpebral fissures and microcephaly are not hallmark signs. Growth retardation suggests a broader spectrum of issues related to insufficient growth but does not specify particular head or eye anomalies. Hydrocephalus involves an accumulation of cerebrospinal fluid within the ventricles of the brain, which can lead to an increased head circumference, but it is not linked to the defined facial features noted in the question. Therefore, fetal alcohol syndrome stands out as the most likely