This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pediatrics
[{'content': "Give the most probable diagnosis of a 1 year. old child of normal intelligence with features of hypotonia. On examination, there are tongue fasciculations and he keeps his body in a frog-like position – \nSelect and explain. \nA. Guillian Barre Syndrome, B. Limb girdle atrophy, C. Down's syndrome, D. Spinal muscular atrophy", 'role': 'user'}, {'content': "Answer: D \nExplanation: Features of hypotonic and frog-like position suggest the diagnosis of Floppy infant syndrome.\n\nFloppy infant syndrome\n\nIn FIS the baby is floppy i.e :\nHe cannot hold his head up, there will be marked head lag as the baby is pulled up from supine to sitting posture.\nA normal infant, on ventral suspension (i.e. supporting the infant with a hand under the chest) keeps his back straight and head slightly up, arms abducted and knees partly flexed. A floppy infant droops, over the hand like an inverted U.\n\nTypical features \n\nHypotonia and decreased muscular activity\nFrog-like posture or other unusual position at rest\nDelay in motor milestones\n\nCauses of Floppy infant syndrome\nCentral nervous system\n\nPerinatal asphyxia, neonatal encephalopathy, kernicterus, cerebral palsy (atonic type), intracranial haemorrhage, chromosomal anomalies including Down syndrome and inborn errors of metabolism e.g., aminoacidurias, mucopolysaccharidosis, and cerebral lipidosis.\n\n\nSpinal cord lesions\n\nAnterior horn cell disease: Werdnig Hoffman spinal muscular atrophy, poliomyelitis\n\nPeripheral nerves\n\nAcute polyneuropathy, familial dysautonomia, congenital sensory neuropathy\n\nMyoneural junction\n\nNeonatal myasthenia gravis, infantile botulism, following antibiotic therapy\n\nMuscles\n\nMuscular dystrophies, congenital myotonic dystrophies, congenital myopathies (including central core disease and Nemaline myopathy), polymyositis, glycogen storage disease (Pompe's), and arthrogryposis multiplex congenital\n\nMiscellaneous\n\nProtein-energy malnutrition, rickets, Prader-Willi syndrome, malabsorption syndromes, Ehler-Danlos syndrome, cutis laxa, cretinism\n\nComing back to question\n\nThere are many causes of floppy infant syndrome.\nOut of the four option given in the question three of these can cause FIS -\nDown’s syndrome\n\n\nGB. syndrome\nSpinal muscular atrophy\n\nSpinal muscular atrophy\n\nFeatures of normal intelligence and tongue fasciculation's strongly suggested spinal muscular atrophy.\n\n\xa0Down's syndrome\n\nCan be easily ruled out as intelligence is impaired in Down's syndrome.\n\nGB. syndrome\n\nCan be ruled out as it presents as an acute case with a past history of fever or viral infections.\nMajority of patients recover within a few days to 2 weeks.", 'role': 'assistant'}]