Which of the following diseases is commonly characterised by Simian creases?

DSSSB 12 August 2024

Child Health Nursing (Pediatrics)

Easy

Appeared in: DSSSB 12 August 2024

Explanation

Down syndrome is a genetic condition caused by the presence of an extra copy of chromosome 21 (Trisomy 21).
One of the classic and most recognized physical findings in individuals with Down syndrome is the presence of a single transverse palmar crease, also known as a Simian crease.
This crease is seen in about 50% of patients with Down syndrome and is a key feature looked for during newborn physical assessment.
Other characteristic features include a flat facial profile, upward-slanting eyes, a small nose, and hypotonia (low muscle tone).

Option A: Deoxy syndrome is not a recognized medical condition or a valid medical term.
Option B: Cushing syndrome is an endocrine disorder related to excess cortisol. Its physical signs, such as moon facies and central obesity, are completely different from the features of Down syndrome.
Option D: Ekbom syndrome, or delusional parasitosis, is a psychiatric disorder. It is a delusional belief and has no associated physical or genetic markers like a Simian crease.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical features of Down syndrome (Trisomy 21) as background academic context rather than a clinical decision trigger.
The presence of a single palmar crease is a significant finding during a newborn assessment. While not exclusive to Down syndrome, it prompts the nurse to look for other associated signs and may lead to a recommendation for genetic testing.
Early diagnosis of Down syndrome is crucial for initiating early intervention programs, including physical, speech, and occupational therapy, which can significantly improve developmental outcomes.
Nurses play a vital role in counseling and supporting parents of a child diagnosed with Down syndrome, providing accurate information and connecting them with support groups and resources.

How to Approach the Question

First, identify the key term in the question: 'Simian creases'. Recognize this as a specific clinical sign.
Recall or deduce that 'Simian crease' is the older term for a single transverse palmar crease.
Systematically evaluate the options. Access your knowledge base about each condition listed.
Eliminate 'Deoxy syndrome' as it is not a standard medical term.
Eliminate 'Cushing syndrome' and 'Ekbom syndrome' by recalling that they are an endocrine and a psychiatric disorder, respectively, with no link to this physical finding.
Confirm the strong association between 'Down syndrome' and the presence of a Simian crease, making it the correct answer.

Concept Tested & Keywords

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

E6 Anatomy Applied Ashalatha 4e p. 469-471

E6 Text Book Of Pediatric Nursing 3rd Panchali Pal — Part 3 (pp 477-702 of 713) p. 93-95