What characteristics are typical in a child diagnosed with Down syndrome? (Select the 4 correct answers.)

Choice A rationale A Simian crease, or single palmar transverse crease, is a characteristic dermatoglyphic feature found in approximately 50. Choice B rationale Individuals with Down syndrome often exhibit clinodactyly, specifically the inward curvature of the fifth (pinky) finger. This is often accompanied by a single flexion crease instead of the typical two on the small finger, making the fingers appear curved and smaller. These skeletal anomalies are common manifestations of the genetic disorder's effect on bone development. Choice C rationale Delayed and irregular eruption of teeth is common in Down syndrome. However, the front teeth (incisors) are often smaller (microdontia) and spaced far apart (diastema), not typically wide-spaced front teeth in the sense of a prominent gap, which is not a primary characteristic. The palate is frequently narrow and high-arched, which contributes to dental irregularities. Choice D rationale A protruding tongue (macroglossia) is a frequent physical characteristic in Down syndrome, resulting from a combination of a relatively small oral cavity, hypotonia (low muscle tone) of the facial and tongue muscles, and an objectively large tongue. This feature contributes to feeding difficulties and articulation challenges, and is a notable manifestation of the disorder. Choice E rationale The eyes in Down syndrome are typically characterized by upward slanting palpebral fissures, epicanthal folds (skin folds at the inner corner of the eyes), and small white spots on the iris (Brushfield spots). The eyes are usually closely set (hypotelorism) or appear so due to the facial structure, rather than being loose-set (widely spaced), which is characteristic of other syndromes.