1. A 6-day-old baby girl is admitted to the NICU and is being evaluated for abnormal movements concerning for seizures. She was born at 36 weeks gestation and was small for gestational age. She has had feeding difficulties and has received phototherapy for jaundice. On examination, she is noted to have small head, hepatosplenomegaly, and a purpuric rash. Routine laboratory studies reveal elevated aminotransferases, direct and indirect hyperbilirubinemia, thrombocytopenia, and hemolytic anemia. Her head circumference is at the 3rd percentile for age and gender. Based on this information, does the baby have microcephaly, what type, and what is the most likely next step in evaluation?
2. A 3-year-old child with a history of developmental delay is brought to your office for evaluation. She was born to a 28-year-old mother with no complications during pregnancy or delivery. At birth, her head circumference was at the 25th percentile, but it now measures at the 2nd percentile. The mother reports concerns about the child's fine motor skills and language development, noting a vocabulary of only 10-15 words. There is no family history of genetic disorders, and the child does not present with any craniofacial abnormalities or systemic concerns. Based on this information, does she have microcephaly, what type, and what are the reasonable next steps in evaluation?
