Archive for 02/04/2012


A 6-year-old boy is brought to your practice by his paternal grandmother for his first visit. She has recently received custody of him after his mother entered the penal system in another state; she does not have much information about him. You note that the child is short for his age, has downslanting palpebral fissures, ptosis, low-set and malformed ears, a broad and webbed neck, shield chest, and cryptorchidism. You hear a systolic ejection murmur at the pulmonic region. His grandmother reports that he does well in regular classes, but has been diagnosed with learning disabilities and receives speech therapy for language delay. His constellation of symptoms is suggestive of which of the following?

a. Noonan syndrome

b. Congenital hypothyroidism

c. Turner syndrome

d. Congenital rubella

e. Down syndrome

the answer is below…

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Inilah catatan perjalanan yang saya janjikan. Posting pertama ini tentang perjalanan kami di hari pertama. Goa X. Kenapa namanya Goa X, karena kami dipesan oleh mas Cetoel agar tidak mengekspos nama asli Goa ini. Karena Goa ini sangat sangat mudah dijangkau maka bila sembarang orang masuk, kami kuatir keindahan goa ini akan rusak oleh tangan-tangan jahil.

Rehat Setelah Mengarungi Sungai Dalam -Praba, Dicky, Bayu, mas Kunto

Goa X adalah Goa horisontal yang biasanya debit airnya tidak terlalu banyak. Namun ketika kami tiba, debit airnya luar biasa banyak. Sejak sekitar 100 m dari mulut goa kami sudah disambut sungai bawah tanah sedalam lutut. Berjalan sedikit, kami menemui sungai dengan kedalaman sekitar 2-3 meter. Kami menyusuri dengan berpegang pada dinding goa, melayang-layang di sungai bawah tanah yang dalam ini. Cukup menegangkan!! Bagi saya, sangat menegangkan!! Karena meski saya bisa berenang, dalam kondisi sangat gelap tentu sulit menemukan arah.

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