<prompt> All the following are features of Downs syndrome exceptBrushfields spots in irisSimian creaseMental retardationHypertonicity  <response>: Clinical features of Downs syndromeA most striking feature in the neonate is hypotonia and although the diagnosis is usually evident at this time, it may sometimes be missed if the baby is very premature or his facial features are concealed by ventilatory apparatus.CLINICAL FEATURES IN DOWN SYNDROMEGeneralNeonatal hypotoniaMild-moderate mental retardationShort StatureCranio-facialBrachycephalyClinodactylyEpicanthic foldsProtruding tongueSmall earsUpward sloping palpebral fissuresStrabismus andor nystagmusBrushfield spots in the irisIncreased incidence of leukaemia 1LimbsFifth finger clinodactylySingle palmar crease simian creaseThe wide gap between first and second toesOtherCongenital heart disease 40 e.g. common atrioventricular canal, ASD, PDA, VSD, Fallot tetralogyAnal atresia Hirschsprung diseaseDuodenal atresia annular pancreasHypothyroidism DMDelayed fontanel closureThree fontanelObesity obstructive sleep apnea 