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Pediatrics · Genetic and metabolic disorders: Friedreich ataxia
Sample itemA 13-year-old has progressive gait ataxia, absent knee and ankle jerks, pes cavus, scoliosis and impaired vibration and position sense. Which accompanying problem is the commonest cause of death?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Hypertrophic cardiomyopathy with arrhythmia
Friedreich ataxia is autosomal recessive, usually from a GAA expansion in the frataxin gene, with mitochondrial iron accumulation. Neurological signs include ataxia, areflexia and posterior column loss, and cardiomyopathy and diabetes mellitus accompany. Cardiac disease is the main cause of premature death.
Option by option
A. Acute liver failure
Liver failure is not a feature of this disorder.
B. Respiratory failure from neuromuscular weakness
Respiratory failure is a feature of motor neurone diseases, not the main cause here.
C. Hypertrophic cardiomyopathy with arrhythmia (correct)
Correct. Cardiomyopathy and arrhythmia are the leading causes of death.
D. Renal failure
Renal failure is not a feature of Friedreich ataxia.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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