Malpresentations (breech, face, brow) US Medical PG Practice Questions and MCQs
Practice US Medical PG questions for Malpresentations (breech, face, brow). These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Malpresentations (breech, face, brow) US Medical PG Question 1: You have been entrusted with the task of finding the causes of low birth weight in infants born in the health jurisdiction for which you are responsible. In 2017, there were 1,500 live births and, upon further inspection of the birth certificates, 108 of these children had a low birth weight (i.e. lower than 2,500 g), while 237 had mothers who smoked continuously during pregnancy. Further calculations have shown that the risk of low birth weight in smokers was 14% and in non-smokers, it was 7%, while the relative risk of low birth weight linked to cigarette smoking during pregnancy was 2%. In other words, women who smoked during pregnancy were twice as likely as those who did not smoke to deliver a low-weight infant. Using this data, you are also asked to calculate how much of the excess risk for low birth weight, in percentage terms, can be attributed to smoking. What is the attributable risk percentage for smoking leading to low birth weight?
- A. 40%
- B. 30%
- C. 20%
- D. 10%
- E. 50% (Correct Answer)
Malpresentations (breech, face, brow) Explanation: ***50%***
- This value is calculated using the formula for **attributable risk percent (ARP)** in the exposed group: ARP = ((Risk in exposed - Risk in unexposed) / Risk in exposed) × 100.
- Given that the risk of low birth weight in smokers (exposed) is 14% and in non-smokers (unexposed) is 7%, the calculation is ((0.14 - 0.07) / 0.14) × 100 = (0.07 / 0.14) × 100 = **0.50 × 100 = 50%**.
*40%*
- This percentage does not align with the provided risk values for low birth weight in smokers (14%) and non-smokers (7%).
- A calculation of ((0.14 - 0.07) / 0.14) * 100 does not yield 40%.
*30%*
- This value is incorrect, as it would suggest a smaller difference in risk between the exposed and unexposed groups relative to the risk in the exposed group than what is presented in the problem.
- The calculated attributable risk percent is higher than 30%.
*20%*
- This option is significantly lower than the true attributable risk percent derived from the given risk figures.
- It would imply a much weaker association between smoking and low birth weight in terms of excess risk than what is calculated.
*10%*
- This value is substantially different from the correct calculation and would suggest a very minor attributable risk.
- The attributable risk percent for smoking leading to low birth weight is much higher than 10% based on the provided data.
Malpresentations (breech, face, brow) US Medical PG Question 2: A 31-year-old G2P1001 presents to the labor floor for external cephalic version (ECV) due to breech presentation at 37 weeks gestation. Her pregnancy has been complicated by an episode of pyelonephritis at 14 weeks gestation, treated with intravenous ceftriaxone. The patient has not had urinary symptoms since that time. Otherwise, her prenatal care has been routine and she tested Rh-negative with negative antibodies at her first prenatal visit. She has a history of one prior spontaneous vaginal delivery without complications. She also has a medical history of anemia. Current medications include nitrofurantoin for urinary tract infection suppression and iron supplementation. The patient’s temperature is 98.5°F (36.9°C), pulse is 75/min, blood pressure is 122/76 mmHg, and respirations are 13/min. Physical exam is notable for a fundal height of 37 centimeters and mild pitting edema in both lower extremities. Cardiopulmonary exams are unremarkable. Bedside ultrasound confirms that the fetus is still in breech presentation. Which of the following should be performed in this patient as a result of her upcoming external cephalic version?
- A. Fibrinogen level
- B. Urinalysis
- C. Urine protein to creatinine ratio
- D. Complete blood count
- E. Rhogam administration (Correct Answer)
Malpresentations (breech, face, brow) Explanation: ***Rhogam administration***
- An **external cephalic version (ECV)** carries a risk of **fetal-maternal hemorrhage** due to manipulation of the uterus and fetus.
- For **Rh-negative mothers**, Rhogam (anti-D immune globulin) administration is crucial to prevent **Rh alloimmunization** if fetal blood enters maternal circulation.
*Fibrinogen level*
- A fibrinogen level is typically checked in cases of suspected **disseminated intravascular coagulation (DIC)** or significant bleeding risk, such as in patients with **placental abruption** or severe pre-eclampsia.
- While bleeding is a potential complication of any obstetric procedure, routine fibrinogen levels are not indicated prior to an ECV in an otherwise healthy patient with no signs of bleeding dyscrasia.
*Urinalysis*
- Although the patient has a history of pyelonephritis and is on nitrofurantoin, she has been **asymptomatic** and a urinalysis was likely performed recently as part of her routine prenatal care.
- While urinary tract infections can be a concern in pregnancy, a urinalysis is not a direct requirement for an ECV unless new urinary symptoms arise.
*Urine protein to creatinine ratio*
- A urine protein to creatinine ratio is used to screen for or confirm **preeclampsia**, a condition characterized by **hypertension and proteinuria**.
- The patient's blood pressure is normal (122/76 mmHg) and there is no mention of proteinuria, so this test is not indicated for the ECV.
*Complete blood count*
- While a complete blood count (CBC) would confirm her known anemia and assess for infection, it is **not directly necessitated by the ECV procedure itself** as a preventive measure against Rh incompatibility.
- The primary concern for an Rh-negative mother undergoing ECV is feto-maternal hemorrhage, making Rhogam the critical intervention.
Malpresentations (breech, face, brow) US Medical PG Question 3: A 34-year-old pregnant woman with unknown medical history is admitted to the hospital at her 36th week of gestation with painful contractions. She received no proper prenatal care during the current pregnancy. On presentation, her vital signs are as follows: blood pressure is 110/60 mm Hg, heart rate is 102/min, respiratory rate is 23/min, and temperature is 37.0℃ (98.6℉). Fetal heart rate is 179/min. Pelvic examination shows a closed non-effaced cervix. During the examination, the patient experiences a strong contraction accompanied by a high-intensity pain after which contractions disappear. The fetal heart rate becomes 85/min and continues to decrease. The fetal head is now floating. Which of the following factors would most likely be present in the patient’s history?
- A. Fundal cesarean delivery (Correct Answer)
- B. Adenomyosis
- C. Intrauterine synechiae
- D. Multiple vaginal births
- E. Postabortion metroendometritis
Malpresentations (breech, face, brow) Explanation: ***Fundal cesarean delivery***
- The sudden onset of intense pain followed by cessation of contractions, fetal bradycardia, and a floating fetal head in a woman with a prior Cesarean section scar is highly suggestive of **uterine rupture**.
- A previous **classical or fundal Cesarean section** scar carries the highest risk of rupture in subsequent pregnancies due to the incision extending into the contractile upper uterine segment.
*Adenomyosis*
- **Adenomyosis** involves the presence of endometrial tissue within the myometrium, which can cause heavy, painful periods and chronic pelvic pain, but it doesn't directly predispose to uterine rupture during labor.
- While it can complicate pregnancy with an increased risk of preterm birth or miscarriage, it is not associated with the acute presentation described.
*Intrauterine synechiae*
- **Intrauterine synechiae**, or Asherman's syndrome, are adhesions within the uterine cavity, often resulting from endometrial trauma.
- They primarily cause infertility, recurrent pregnancy loss, or abnormal placentation (like placenta accreta), but not uterine rupture.
*Multiple vaginal births*
- A history of **multiple vaginal births** generally *reduces* the risk of uterine rupture in subsequent pregnancies as the cervix and lower uterine segment are often more compliant.
- While prolonged labor or instrumental delivery can rarely increase rupture risk, it's not a primary risk factor like a prior classical Cesarean.
*Postabortion metroendometritis*
- **Postabortion metroendometritis** is an infection of the uterus after an abortion.
- While it can lead to complications such as Asherman's syndrome or infertility, it does not typically increase the risk of uterine rupture in a subsequent pregnancy in the manner described.
Malpresentations (breech, face, brow) US Medical PG Question 4: A 6-hour-old newborn male is noted to have a “lump on his head” by his mother. She denies that the lump was present at birth and is concerned about an infection. The child was born at 39 weeks gestation to a 34-year-old gravida 2 by vacuum-assisted vaginal delivery after a prolonged labor. The child’s birth weight was 3.8 kg (8.4 lb), and his length and head circumference are at the 40th and 60th percentiles, respectively. The mother was diagnosed during this pregnancy with gestational diabetes mellitus and received prenatal care throughout. All prenatal screening was normal, and the 20-week anatomy ultrasound was unremarkable. On physical exam, the child is in no acute distress. He has a 3x3 cm fluctuant swelling over the right parietal bone that does not cross the midline. There is no discoloration of the overlying scalp. Laboratory testing is performed and reveals the following:
Total bilirubin: 5.5 mg/dL
Direct bilirubin: 0.7 mg/dL
Which of the following is the best next step in management?
- A. Observation only (Correct Answer)
- B. Neurosurgical decompression
- C. Incision and drainage
- D. Red blood cell transfusion
- E. Intensive phototherapy
Malpresentations (breech, face, brow) Explanation: ***Observation only***
- The presentation of a **fluctuant swelling** over the parietal bone that **does not cross suture lines**, developing hours after a vacuum-assisted delivery, is classic for a **cephalohematoma**.
- **Cephalohematoma** is a benign condition that typically resolves spontaneously over weeks to months, requiring only observation unless complications like significant hyperbilirubinemia or infection develop.
*Neurosurgical decompression*
- This intervention is reserved for severe cranial conditions such as **epidural hematoma** or **depressed skull fracture** with neurological compromise.
- A cephalohematoma is generally **extra-cranial** and does not compress the brain, thus not warranting neurosurgical intervention.
*Incision and drainage*
- **Incision and drainage (I&D)** of a cephalohematoma is usually contraindicated due to the high risk of **infection** and potential for secondary complications.
- This procedure should only be considered in rare cases of confirmed infection or extremely prolonged resolution, which is not indicated here.
*Red blood cell transfusion*
- A red blood cell transfusion would be indicated for **severe anemia**, typically due to significant blood loss.
- While a cephalohematoma involves blood accumulation, the volume is usually not significant enough to cause severe anemia warranting transfusion, and no anemic symptoms or lab values are described.
*Intensive phototherapy*
- Phototherapy is used to treat **significant hyperbilirubinemia** in newborns. The total bilirubin of 5.5 mg/dL reported here is within the normal range for a 6-hour-old infant.
- While cephalohematomas can lead to **hyperbilirubinemia** due to blood breakdown, the current bilirubin level does not meet the criteria for intensive phototherapy, and observation of bilirubin levels would be the initial step if elevation was concerning.
Malpresentations (breech, face, brow) US Medical PG Question 5: A 31-year-old woman delivers a healthy boy at 38 weeks gestation. The delivery is vaginal and uncomplicated. The pregnancy was unremarkable. On examination of the newborn, it is noted that his head is tilted to the left and his chin is rotated to the right. Palpation reveals no masses or infiltration in the neck. The baby also shows signs of left hip dysplasia. Nevertheless, the baby is active and exhibits no signs of other pathology. What is the most probable cause of this patient's condition?
- A. Basal ganglia abnormalities
- B. Antenatal trauma
- C. Congenital infection
- D. Accessory nerve palsy
- E. Intrauterine malposition (Correct Answer)
Malpresentations (breech, face, brow) Explanation: ***Intrauterine malposition***
- The combination of **congenital muscular torticollis** (head tilted left, chin rotated right) and **hip dysplasia** in a newborn strongly suggests **intrauterine confinement**.
- **Malposition** *in utero* can restrict fetal movement and lead to musculoskeletal abnormalities due to prolonged pressure on developing structures.
*Basal ganglia abnormalities*
- **Basal ganglia abnormalities** typically present with movement disorders such as dyskinesias, dystonia, or rigidity, often without the specific musculoskeletal findings described.
- While they can cause abnormal posturing, the concurrent **hip dysplasia** points away from a primary neurological cause.
*Antenatal trauma*
- **Antenatal trauma** (trauma occurring during pregnancy before labor) severe enough to cause these musculoskeletal findings would typically require significant force and would likely present with other signs of injury or complications during pregnancy.
- The **unremarkable pregnancy** and **uncomplicated delivery** make trauma an unlikely cause.
- These findings are better explained by chronic positional constraint rather than acute traumatic injury.
*Congenital infection*
- **Congenital infections** such as TORCH infections usually present with a broader range of symptoms including systemic illness, neurological impairments (e.g., microcephaly, seizures), or specific organ damage.
- The isolated musculoskeletal findings of torticollis and hip dysplasia, without other signs, are not characteristic of a congenital infection.
*Accessory nerve palsy*
- **Accessory nerve palsy** would primarily affect the **sternocleidomastoid** and **trapezius muscles**, leading to weakness and potentially torticollis.
- However, it would not explain the associated **hip dysplasia**, making it an incomplete diagnosis for the overall presentation.
Malpresentations (breech, face, brow) US Medical PG Question 6: A 24-year-old primigravid woman at 38 weeks' gestation comes to the physician for a prenatal visit. At the last two prenatal visits, transabdominal ultrasound showed the fetus in breech presentation. She has no medical conditions and only takes prenatal vitamins. Her pulse is 95/min, respirations are 16/min, and blood pressure is 130/76 mm Hg. The abdomen is soft and nontender; no contractions are felt. Pelvic examination shows a closed cervical os and a uterus consistent with 38 weeks' gestation. The fetal rate tracing shows a baseline heart rate of 152/min and 2 accelerations over 10 minutes. Repeat ultrasound today shows a persistent breech presentation. The patient states that she would like to attempt a vaginal delivery. Which of the following is the most appropriate next step in management?
- A. Offer internal podalic version
- B. Offer external cephalic version (Correct Answer)
- C. Repeat ultrasound in one week
- D. Observe until spontaneous labor
- E. Recommend cesarean section
Malpresentations (breech, face, brow) Explanation: ***Offer external cephalic version***
- External cephalic version (ECV) is the most appropriate next step for a **term pregnancy with persistent breech presentation** in a woman who desires a vaginal delivery, given there are no contraindications.
- It is a procedure performed to manually turn the fetus from a breech to a cephalic presentation, potentially allowing for a **vaginal birth** and avoiding a cesarean section.
*Offer internal podalic version*
- Internal podalic version is a procedure primarily used for the **second twin during a vaginal delivery** or in specific cases of significant fetal distress during labor, not as an initial attempt for a singleton breech presentation at term.
- It involves inserting a hand into the uterus to grasp the fetal feet and turn the fetus, carrying **higher risks** than ECV.
*Repeat ultrasound in one week*
- Repeating an ultrasound in one week is unlikely to change the fetal presentation as the woman is already at **38 weeks' gestation**, and spontaneous version is rare at this stage.
- This delay would **prolong the breech presentation** and reduce the window of opportunity for a successful ECV.
*Observe until spontaneous labor*
- Observing until spontaneous labor would mean the baby would likely remain in a **breech presentation**, necessitating either a planned cesarean section or a complicated breech vaginal delivery with increased risks.
- Allowing labor to begin with a breech presentation **limits options** and increases the likelihood of a C-section or potential complications.
*Recommend cesarean section*
- While a cesarean section is an option for breech presentation, it is generally reserved for cases where ECV is unsuccessful or contraindicated, or if the woman prefers it.
- Given the patient's desire to attempt a vaginal delivery and no contraindications, ECV should be **offered first** before recommending a C-section.
Malpresentations (breech, face, brow) US Medical PG Question 7: A 28-year-old male presents to his primary care physician with complaints of intermittent abdominal pain and alternating bouts of constipation and diarrhea. His medical chart is not significant for any past medical problems or prior surgeries. He is not prescribed any current medications. Which of the following questions would be the most useful next question in eliciting further history from this patient?
- A. "Does the diarrhea typically precede the constipation, or vice-versa?"
- B. "Is the diarrhea foul-smelling?"
- C. "Please rate your abdominal pain on a scale of 1-10, with 10 being the worst pain of your life"
- D. "Are the symptoms worse in the morning or at night?"
- E. "Can you tell me more about the symptoms you have been experiencing?" (Correct Answer)
Malpresentations (breech, face, brow) Explanation: ***Can you tell me more about the symptoms you have been experiencing?***
- This **open-ended question** encourages the patient to provide a **comprehensive narrative** of their symptoms, including details about onset, frequency, duration, alleviating/aggravating factors, and associated symptoms, which is crucial for diagnosis.
- In a patient presenting with vague, intermittent symptoms like alternating constipation and diarrhea, allowing them to elaborate freely can reveal important clues that might not be captured by more targeted questions.
*Does the diarrhea typically precede the constipation, or vice-versa?*
- While knowing the sequence of symptoms can be helpful in understanding the **pattern of bowel dysfunction**, it is a very specific question that might overlook other important aspects of the patient's experience.
- It prematurely narrows the focus without first obtaining a broad understanding of the patient's overall symptomatic picture.
*Is the diarrhea foul-smelling?*
- Foul-smelling diarrhea can indicate **malabsorption** or **bacterial overgrowth**, which are important to consider in some gastrointestinal conditions.
- However, this is a **specific symptom inquiry** that should follow a more general exploration of the patient's symptoms, as it may not be relevant if other crucial details are missed.
*Please rate your abdominal pain on a scale of 1-10, with 10 being the worst pain of your life*
- Quantifying pain intensity is useful for assessing the **severity of discomfort** and monitoring changes over time.
- However, for a patient with intermittent rather than acute, severe pain, understanding the **character, location, and triggers** of the pain is often more diagnostically valuable than just a numerical rating initially.
*Are the symptoms worse in the morning or at night?*
- Diurnal variation can be relevant in certain conditions, such as inflammatory bowel diseases where nocturnal symptoms might be more concerning, or functional disorders whose symptoms might be stress-related.
- This is another **specific question** that should come after gathering a more complete initial picture of the patient's symptoms to ensure no key information is overlooked.
Malpresentations (breech, face, brow) US Medical PG Question 8: A 35-year-old woman, gravida 4, para 3, at 34 weeks' gestation comes to the physician for a prenatal visit. She feels well. She does not note any contractions or fluid from her vagina. Her third child was delivered spontaneously at 35 weeks' gestation; pregnancy and delivery of her other two children were uncomplicated. Vital signs are normal. The abdomen is nontender and no contractions are felt. Pelvic examination shows a uterus consistent in size with a 34-weeks' gestation. Ultrasonography shows the fetus in a breech presentation. The fetal heart rate is 148/min. Which of the following is the most appropriate next step in management?
- A. Internal cephalic version
- B. Intravenous penicillin
- C. Cesarean section
- D. Observation (Correct Answer)
- E. External cephalic version
Malpresentations (breech, face, brow) Explanation: ***Observation***
- At 34 weeks' gestation, **spontaneous version** from **breech to cephalic presentation** can still occur, especially in multiparous women.
- Waiting until 37 weeks allows time for the fetus to turn naturally before considering interventions.
*Internal cephalic version*
- This procedure involves a physician inserting a hand into the uterus to manually turn the fetus from inside.
- It is typically performed during **labor** to correct a **malpresentation** once the cervix is dilated sufficiently and is not appropriate for an antepartum breech presentation.
*Intravenous penicillin*
- **Penicillin** is administered to prevent **Group B Streptococcus (GBS) transmission** to the neonate, usually during labor for GBS-positive mothers.
- There is no indication for **GBS prophylaxis** in this case, and GBS status is not provided.
*Cesarean section*
- While breech presentation often necessitates a **cesarean section**, it is generally planned for 39 weeks' gestation or when labor begins if other interventions fail.
- It is premature to schedule a **C-section** at 34 weeks, as the fetus might still undergo spontaneous version.
*External cephalic version*
- This procedure involves manually manipulating the fetus through the maternal abdomen to turn it from breech to cephalic.
- It is usually attempted at **37 weeks' gestation** to maximize success rates and minimize risks, as earlier attempts have lower success and higher re-version rates.
Malpresentations (breech, face, brow) US Medical PG Question 9: A 27-year old primigravid woman at 37 weeks' gestation comes to the emergency department because of frequent contractions for 4 hours. Her pregnancy has been complicated by hyperemesis gravidarum which subsided in the second trimester. The contractions occur every 10–15 minutes and have been increasing in intensity and duration since onset. Her temperature is 37.1°C (98.8°F), pulse is 110/min, and blood pressure is 140/85 mm Hg. Uterine contractions are felt on palpation. Pelvic examination shows clear fluid in the vagina. The cervix is 50% effaced and 3 cm dilated. After 4 hours the cervix is 80% effaced and 6 cm dilated. Pelvic examination is inconclusive for the position of the fetal head. The fetal heart rate is reassuring. Which of the following is the most appropriate next step?
- A. Administer oxytocin
- B. Perform external cephalic version
- C. Administer misoprostol
- D. Perform Mauriceau-Smellie-Veit maneuver
- E. Perform ultrasonography (Correct Answer)
Malpresentations (breech, face, brow) Explanation: ***Perform ultrasonography***
- The examination notes that the **pelvic examination is inconclusive for the position of the fetal head**, which is a critical piece of information needed for safe delivery. **Ultrasonography** is the most appropriate next step to ascertain the fetal presentation and position, especially given the dilated cervix.
- Determining fetal position is essential to rule out **malpresentation**, such as **breech** or **transverse lie**, which would significantly impact the delivery plan and potentially necessitate a **cesarean section**.
*Administer oxytocin*
- **Oxytocin** is used to induce or augment labor when contractions are insufficient or labor is prolonged, but in this case, the cervix is progressing well (from 3 cm to 6 cm dilation in 4 hours), indicating **active labor**.
- Without knowing the fetal presentation, administering oxytocin could exacerbate issues if there's a **malpresentation**, potentially leading to **fetal distress** or **uterine rupture**.
*Perform external cephalic version*
- **External cephalic version (ECV)** is performed to change a **breech presentation** to a **cephalic presentation** by external manipulation, typically done before labor onset or early in labor at term.
- This patient is already in **active labor** with significant cervical dilation (6 cm), making ECV less likely to be successful and potentially increasing risks like **placental abruption** or **umbilical cord compression**.
*Administer misoprostol*
- **Misoprostol** is a prostaglandin analog used for **cervical ripening** and **labor induction** in cases where the cervix is unfavorable or labor needs to be initiated.
- This patient is already in **active labor** with progressive cervical dilation, making misoprostol unnecessary and potentially harmful due to the risk of **uterine hyperstimulation**.
*Perform Mauriceau-Smellie-Veit maneuver*
- The **Mauriceau-Smellie-Veit maneuver** is a technique used during a **vaginal breech delivery** to deliver the fetal head, specifically in cases of **frank or complete breech** that are being delivered vaginally.
- This maneuver is only performed *during* delivery of a breech baby, and the fetal position is currently unknown. It would be premature and inappropriate to consider this maneuver without first confirming a **breech presentation** and the decision for vaginal delivery.
Malpresentations (breech, face, brow) US Medical PG Question 10: A 26-year-old gravida 3 para 1 is admitted to labor and delivery with uterine contractions. She is at 37 weeks gestation with no primary care provider or prenatal care. She gives birth to a boy after an uncomplicated vaginal delivery with APGAR scores of 7 at 1 minute and 8 at 5 minutes. His weight is 2.2 kg (4.4 lb) and the length is 48 cm (1.6 ft). The infant has weak extremities and poor reflexes. The physical examination reveals microcephaly, palpebral fissures, thin lips, and a smooth philtrum. A systolic murmur is heard on auscultation. Identification of which of the following factors early in the pregnancy could prevent this condition?
- A. Phenytoin usage
- B. Maternal hypothyroidism
- C. Alcohol consumption (Correct Answer)
- D. Physical abuse
- E. Maternal toxoplasmosis
Malpresentations (breech, face, brow) Explanation: ***Alcohol consumption***
- The constellation of **microcephaly**, **palpebral fissures**, **thin lips**, **smooth philtrum**, and **cardiac defects** (systolic murmur) in an infant points to **Fetal Alcohol Syndrome (FAS)**.
- **FAS** is entirely preventable if alcohol is avoided during pregnancy, especially early in gestation, as there is no safe amount or time to drink alcohol during pregnancy.
*Phenytoin usage*
- **Phenytoin** is associated with **fetal hydantoin syndrome**, which can present with microcephaly, distinct facial features (e.g., broad nasal bridge, epicanthal folds), and hypoplastic nails, but typically not the specific facial features of FAS.
- While it is a teratogen, preventing its use would not specifically address the described clinical picture, which strongly aligns with alcohol exposure.
*Maternal hypothyroidism*
- **Untreated maternal hypothyroidism** can lead to **neurodevelopmental delays** and **cognitive impairment** in the child.
- It does not, however, cause the characteristic facial dysmorphology or cardiac defects seen in FAS.
*Physical abuse*
- **Physical abuse** does not cause congenital malformations or a specific syndrome evident at birth like FAS.
- While it is a serious concern for maternal and fetal well-being, it is not a direct teratogenic cause of the described neonatal findings.
*Maternal toxoplasmosis*
- **Congenital toxoplasmosis** can cause hydrocephalus, chorioretinitis, and intracranial calcifications.
- It does not cause the specific facial dysmorphology, cardiac defects, or microcephaly seen in this infant.
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