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ABFM Care Of Children 2023 Questions And Answers 100% Score!!!
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ABFM Care Of Children 2023 Questions And Answers100% Score!!!
Quiz :A 30-year-old female who is hepatitis B surface antigen (HBsAg)-positive
gives birth to a 2800-g (6 lb 3 oz) male. Which one of the following is essential
in the care of this newborn during his first 12-24 hours of life?
A. A hepatitis profile
B. Adefovir dipivoxil (Hepsera)
C. Hepatitis A vaccine
D. Hepatitis B immune globulin and hepatitis B vaccine - Answer :ANSWER: D
Approximately 1000 new cases of perinatal hepatitis B infection are identified
in the United States each year. Mother-to-child transmission is responsible for
more than one-third of chronic hepatitis B virus infections worldwide.
Prevention of perinatal hepatitis B depends on the timely administration of
appropriate postexposure immunoprophylaxis to infants born to mothers who
are hepatitis B surface antigen (HBsAg)-positive or whose hepatitis B status is
unknown. The risk of perinatal transmission among infants born to HBsAg-
positive mothers is as high as 90% without immunoprophylaxis, which has
been shown to be 85%-95% efficacious for preventing mother-to-child
transmission.
The American Academy of Pediatrics endorses the recommendation of the
CDC's Advisory Committee on Immunization Practices (ACIP) that all newborn
infants with a birth weight ≥2000 g (4 lb 7 oz) receive hepatitis B vaccine by 12-
24 hours of age.
Infants born to mothers who are HBsAg-positive or whose HBsAg status is
unknown should receive hepatitis B vaccine and hepatitis B immune globulin in
separate limbs within 12 hours of birth. The dosing and administration of these
do not require adjustment for birth weight. Infants who receive appropriate
immunoprophylaxis may breastfeed immediately after birth.
The schedule for subsequent doses of the vaccine depends upon the infant's
birth weight. If the birth weight is ≥2000 g, the second and third doses should
be given at 1 and 6 months of age, respectively. For infants who weigh <2000
g, three additional doses are required and should be given at 1, 2-3, and 6
months of age, or at 2, 4, and 6 months of age.
,Since this is prophylactic, treatment of the infant for an active infection with an
antiviral medication such as adefovir dipivoxil is unnecessary. A hepatitis
profile to check for H
Quiz :Exclusively breastfed infants have higher rates of which one of the
following?
A. Leukemia
B. Obesity
C. Otitis media
D. Rickets
E. Sudden infant death syndrome - Answer :ANSWER: D
The benefits of breastfeeding are numerous, including reductions in a number
of infectious diseases, such as otitis media, respiratory infections, bacterial
meningitis, bacteremia, diarrhea, necrotizing enterocolitis, and urinary tract
infections. The rates of other adverse health outcomes are also reduced,
including sudden infant death syndrome in the first year of life, type 1
diabetes, lymphoma, leukemia, overweight, obesity, hypercholesterolemia,
and asthma.
Studies have shown that up to 96% of children who have rickets were
breastfed, as the small amount of vitamin D in breast milk is inadequate for
preventing this condition in infants or children. While development of rickets
requires the severe vitamin D deficiency seen in less wealthy countries, cases
are still diagnosed in the United States. Subclinical vitamin D deficiency is more
prevalent in breastfed infants, and it can be associated with complications of
insufficient bone density in later life. The American Academy of Pediatrics
recommends that all breastfed infants receive 400 IU of oral vitamin D drops
daily, beginning the first few days of life and continuing until the infant's daily
intake of vitamin D-fortified formula or milk is at least 500 mL.
Quiz :On a routine examination an otherwise healthy 4-month-old male is
found to have a flattened right occiput, with the right ear slightly anterior to
the left ear. The child's posterior fontanelle is closed and the anterior
fontanelle is open, measuring 2.5×2.0 cm. No other abnormal findings are
noted on examination.
The most likely cause of this deformity is
A. craniosynostosis
B. esotropia
, C. sleeping on his back
D. torticollis, or "wry neck" - Answer :ANSWER: C
The prevalence of deformational plagiocephaly, or positional head flattening,
has been increasing steadily since the early 1990s when the "Back to Sleep"
campaign began recommending that infants be placed on their backs for sleep
to prevent sudden infant death syndrome. Positional skull deformities are
generally benign and reversible, decreasing in frequency in proportion to
increasing age. These do not require surgical intervention, as opposed to
craniosynostosis, which can result in neurologic damage and progressive
craniofacial distortion.
Routine evaluation of the skull in newborns and infants includes palpation of
the sutures, evaluation of the posterior and anterior fontanelles, and palpation
of the sternocleidomastoid muscles to detect torticollis. An abnormal
fontanelle or a raised firm edge along the sutures can indicate the possibility of
craniosynostosis, a relatively rare condition in which the sutures close too
early. The posterior fontanelle may be closed at birth and is usually closed by
2-4 months of age. The anterior fontanelle usually is open until at least the
fourth month, and commonly until 2-2½ years of age.
Children may hold their head in an abnormal position if they have severe
esotropia, creating either real or perceived changes in skull growth.
A lump in the sternocleidomastoid muscle may indicate that the child has had
either hemorrhage or scarring into that muscle, which can result in torticollis
and deformity of the skull as the sternocleidomastoid muscle pulls on that side
of the head.
In most cases, positional plagiocephaly can be treated with a combined
approach of physical therapy and repositioning, which is more effective than
repositioning alone. A custom-fitted cranial molding orthosis (helmet) designed
to relieve pressure on the flattened side should only be used in t
Quiz :You are seeing a 12-month-old healthy female for a routine well care
visit. Her mother had an uncomplicated pregnancy, and the birth history and
newborn nursery period were also without complications. She has been seen
for all age-appropriate well child visits and is up to date on immunizations. Her
growth and development have progressed normally since birth and she is in
the 50th percentile for height and weight.
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