A 6-Year-Old Boy Is Brought to the Office by His

A 6-year-old boy is brought to the office by his mother due to behavioral difficulties at school.  His teacher has said, "He interrupts the class, doesn't listen, and cannot sit still for more than a few minutes."  He has been sent home on a few occasions for hitting other children and taking their toys.  The patient was adopted at age 6 months and his birth history is unknown.  He runs around the office playing with various toys and is easily distracted.  Vital signs are within normal limits.  Weight and height are tracking on the 10th percentile, and head circumference is below the 5th percentile for age and sex.  Physical examination reveals short palpebral fissures, a smooth philtrum, thin upper lip, and difficulty with both gross and fine motor coordination.  Which of the following is the likely cause of this patient's condition?

A) CGG trinucleotide repeat
B) Intrauterine alcohol exposure
C) Intrauterine cocaine exposure
D) Intrauterine rubella exposure
E) Trisomy 18
F) Trisomy 21

Correct Answer:

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