Which characteristic feature could be seen among children with Down's Syndrome?

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2019

Explanation

A flat facial profile and upward-slanting eyes (palpebral fissures) are hallmark physical signs of Down's Syndrome.
These features are due to the presence of an extra copy of chromosome 21, which alters typical physical development.
Other associated facial features include a small nose with a depressed nasal bridge and epicanthal folds (skin folds at the inner corner of the eye).
The image provided clearly demonstrates these classic facial characteristics, confirming the diagnosis visually.

Option A: Macrocephaly (abnormally large head) with a prominent occiput is not a feature of Down's Syndrome. Instead, they typically have brachycephaly (a short, broad head) with a flattened occiput.
Option C: This is the opposite of the actual feature. Children with Down's Syndrome have a small nose with a low or flattened nasal bridge, contributing to the overall flat facial appearance.
Option D: Children with Down's Syndrome characteristically have short, broad hands. A single transverse palmar crease (also known as a simian crease) is found in about 50% of individuals, which is different from the typical three creases.

Clinical Relevance

Nursing practice connection: Knowing Physical characteristics of Down's Syndrome (Trisomy 21) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Early recognition of the physical features of Down's Syndrome is crucial for timely diagnosis and initiation of appropriate health screenings.
Nurses play a key role in identifying these signs in newborns, providing support to the family, and coordinating care.
All newborns with suspected Down's Syndrome require a comprehensive evaluation, including an echocardiogram to screen for congenital heart defects (present in ~40-50% of cases) and thyroid function tests.

How to Approach the Question

First, analyze the question, which asks for a characteristic feature of Down's Syndrome.
Examine the provided image. Observe the child's facial features: note the flat profile, the shape of the eyes, and the structure of the nose.
Recall the classic physical stigmata associated with Down's Syndrome (Trisomy 21).
Evaluate each option against your knowledge and visual analysis.
Option A (Macrocephaly/prominent occiput) is a feature of Trisomy 18.
Option B (Flat face/upward slanting eyes) matches the classic description and the image.

Concept Tested & Keywords

Concept Tested: Physical characteristics of Down's Syndrome (Trisomy 21)
Stem keywords: Down's Syndrome, characteristic feature, children
Lead-in keywords: Which
Clinical cues: The question asks for a 'characteristic feature', implying a common and recognizable sign of the condition.

QlRrBNe8iV9LtsAAPriAVf

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 667-669

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 pp. 410-412, 395-397

Practise the full RUHS, Jaipur, PB B.Sc Nursing Entrance-2019

Attempt every question from this paper in a timed mock, then review the full solution for each one.