**Question:** By 2 weeks of age, infants normally show all of the following signs Except

A. Respiratory distress
B. Jaundice
C. Abdominal distension
D. Hypotonia

**Core Concept:** In infants, various physiological, anatomical, and physiological changes occur during the first two weeks of life that are considered normal and may be observed in clinical examinations. These changes are essential to understand for assessing the overall health and development of a newborn.

**Why the Correct Answer is Right:** Hypotonia (low muscle tone) is a sign that is typically observed in infants during the first few weeks of life, particularly in the first few days after birth. It is a normal physiological adaptation that helps infants to maintain a stable blood pressure while adjusting to extrauterine life. By two weeks of age, this hypotonia should have resolved, and increased muscle tone, reflexes, and strength should be present.

**Why Each Wrong Option is Incorrect:**

A. Respiratory distress: Respiratory distress is not a normal finding in infants by two weeks of age. It is characterized by difficulty breathing, rapid breathing, and cyanosis, which could indicate respiratory infections, meconium aspiration, or congenital anomalies.

B. Jaundice: Jaundice is a common condition in neonates caused by increased bilirubin levels due to immature liver function. However, by two weeks of age, jaundice should have resolved or significantly decreased, unless due to underlying pathological conditions.

C. Abdominal distension: Abdominal distension can be seen in infants due to normal gastrointestinal gas and distension, but it is not a normal finding by two weeks of age. If present, it could indicate malabsorption, gastrointestinal infections, or other gastrointestinal problems.

**Clinical Pearl:** It is essential for healthcare professionals to differentiate normal findings from abnormal signs and symptoms in infants to accurately diagnose and manage any potential health concerns. A thorough clinical examination and understanding of physiological changes are crucial for proper assessment and intervention in pediatric patients.

**Correct Answer:** D. Hypotonia (low muscle tone) is not a normal finding in infants by two weeks of age. Hypotonia is a common physiological adaptation in the first few weeks of life, helping infants to maintain stable blood pressure as they adjust to extrauterine life. By two weeks of age, this hypotonia should have resolved, and infants should exhibit increased muscle tone, reflexes, and strength.