A 5-year-old boy shows no interest in other children and ignores adults other than his parents. He spends hours lining up his toy cars or spinning their wheels but does not use them for “make-believe” play. He rarely uses speech to communicate, and his parents state that he has never done so. Physical examination indicates that his head is of normal circumference and his gait is normal. Which of the following is the most likely diagnosis for this boy?
a. Obsessive-compulsive disorder
b. Asperger’s syndrome
c. Childhood disintegrative disorder
e. Rett’s disorder
the answer is below…
The United States Medical Licensing Examination, or USMLE for short, is a three-part licensing examination that is required in order to receive a license to practice medicine within the United States.
The USMLE assesses a physician’s ability to apply knowledge, concepts, and principles, and to determine fundamental patient-centered skills that are important in health and disease and that constitute the basis of safe and effective patient care.Examination committees composed of medical educators and clinicians from across the United States and its territories prepare the examination materials each year.
This exam is designed by the Federation of State Medical Boards and the National Board of Medical Examiners to determine whether or not an individual understands and can apply the knowledge necessary to practice medicine safely and intelligently.
The USMLE is actually comprised of three different exams that are referred to as steps, which examine the individual’s knowledge of specific topics related to the field of medicine such as basic science, medical knowledge, medical skills, clinical science, and the application of all of these skills and areas of knowledge in the medical field.
All three steps of the USMLE include a series of computerized multiple-choice questions, but the format of the exam and the information covered in each multiple-choice section is different for each step of the USMLE. The USMLE Step II also has a clinical skills portion that examines an individual’s ability to work with real patients and the USMLE Step III has a computerized patient simulation portion in addition to the multiple-choice section of the exam. In order for an individual to receive a license to practice medicine, the individual must pass all three steps of the USMLE.
The correct answer is d; Autism.
Autistic disorder is characterized by lack of interest in social interactions, severely impaired verbal and nonverbal communication, stereotyped behaviors, and a very restricted range of interests. Children with autism do not involve themselves in imaginative and imitative play and can spend hours lining and spinning things or dismantling toys and putting them together. Patients with obsessive-compulsive disorder may spend hours on repetitive tasks (such as lining up toys) but do not show the difficulties with language and social interaction that this patient displays. Patients with Asperger’s syndrome show no clinically significant delay in spoken or receptive language development, making this diagnosis unlikely. Patients with childhood disintegrative disorder have approximately a two-year period of normal development (including speech and interpersonal skills) before this regresses; this patient has never apparently had such a period. Patients with Rett’s disorder by the age of 5 would be expected to have microcephaly and a disordered gait (unsteady and stiff).