ABFM Care of Children 2025/2026
A 30-year-antique girl who's hepatitis B floor antigen (HBsAg)-superb gives birth to a 2800-g
(6 lb three ounces) male. Which one of the following is important in the care of this new child
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 - ANSANSWER: D
Approximately a thousand new cases of perinatal hepatitis B contamination are identified
inside the United States each year. Mother-to-toddler transmission is chargeable for more
than one-1/3 of chronic hepatitis B virus infections global. Prevention of perinatal hepatitis B
depends at the well timed management of suitable postexposure immunoprophylaxis to
babies born to mothers who're hepatitis B floor antigen (HBsAg)-high-quality or whose
hepatitis B reputation is unknown. The threat of perinatal transmission among infants born to
HBsAg-high-quality mothers is as high as 90% without immunoprophylaxis, which has been
shown to be eighty five%-95% efficacious for preventing mom-to-infant transmission.
The American Academy of Pediatrics endorses the recommendation of the CDC's Advisory
Committee on Immunization Practices (ACIP) that every one newborn toddlers with a
beginning weight ≥2000 g (four lb 7 oz.) get hold of hepatitis B vaccine by 12-24 hours of
age.
Infants born to moms who're HBsAg-high quality or whose HBsAg reputation is unknown
should obtain hepatitis B vaccine and hepatitis B immune globulin in separate limbs inside
12 hours of start. The dosing and administration of these do not require adjustment for
delivery weight. Infants who receive appropriate immunoprophylaxis might also breastfeed
right now after delivery.
The schedule for subsequent doses of the vaccine depends upon the infant's beginning
weight. If the birth weight is ≥2000 g, the second one and third doses should take delivery of
at 1 and six months of age, respectively. For toddlers who weigh <2000 g, 3 additional doses
are required and ought to accept at 1, 2-3, and 6 months of age, or at 2, 4, and six months of
age.
Since that is prophylactic, remedy of the infant for an lively infection with an antiviral
medication which include adefovir dipivoxil is not sensible. A hepatitis profile to test for
HBsAg
Exclusively breastfed babies have better charges of which one of the following?
A. Leukemia
B. Obesity
,C. Otitis media
D. Rickets
E. Sudden little one demise syndrome - ANSANSWER: D
The benefits of breastfeeding are severa, which includes reductions in a number of
infectious diseases, including otitis media, breathing infections, bacterial meningitis,
bacteremia, diarrhea, necrotizing enterocolitis, and urinary tract infections. The prices of
different detrimental fitness effects also are reduced, together with sudden little one loss of
life syndrome within the first 12 months of life, kind 1 diabetes, lymphoma, leukemia,
overweight, obesity, hypercholesterolemia, and bronchial asthma.
Studies have shown that as much as ninety six% of youngsters who have rickets had been
breastfed, as the small quantity of nutrition D in breast milk is inadequate for preventing this
circumstance in toddlers or children. While development of rickets calls for the intense diet D
deficiency visible in less wealthy nations, instances are still identified inside the United
States. Subclinical diet D deficiency is more customary in breastfed babies, and it could be
related to headaches of inadequate bone density in later lifestyles. The American Academy
of Pediatrics recommends that each one breastfed babies get hold of 400 IU of oral nutrition
D drops every day, beginning the primary few days of existence and continuing until the
toddler's day by day consumption of nutrition D-fortified system or milk is as a minimum 500
mL.
On a recurring exam an in any other case wholesome four-month-vintage male is discovered
to have a flattened right occiput, with the proper ear slightly anterior to the left ear. The
infant's posterior fontanelle is closed and the anterior fontanelle is open, measuring 2.5×2.0
cm. No other abnormal findings are cited on exam.
The most likely cause of this deformity is
A. Craniosynostosis
B. Esotropia
C. Napping on his again
D. Torticollis, or "wry neck" - ANSANSWER: C
The incidence of deformational plagiocephaly, or positional head knocking down, has been
increasing progressively because the early Nineties whilst the "Back to Sleep" marketing
campaign commenced recommending that babies be positioned on their backs for sleep to
prevent unexpected toddler death syndrome. Positional cranium deformities are normally
benign and reversible, reducing in frequency in proportion to growing age. These do no
longer require surgical intervention, as opposed to craniosynostosis, that may bring about
neurologic damage and progressive craniofacial distortion.
Routine evaluation of the skull in newborns and toddlers consists of palpation of the sutures,
evaluation of the posterior and anterior fontanelles, and palpation of the sternocleidomastoid
muscle tissues to come across torticollis. An strange fontanelle or a raised firm facet
alongside the sutures can imply the opportunity of craniosynostosis, a fairly rare situation
wherein the sutures close too early. The posterior fontanelle may be closed at beginning and
is commonly closed by 2-four months of age. The anterior fontanelle typically is open until at
least the fourth month, and typically until 2-2½ years of age.
, Children might also preserve their head in an peculiar position if they have extreme
esotropia, growing either actual or perceived changes in skull growth.
A lump within the sternocleidomastoid muscle can also suggest that the kid has had both
hemorrhage or scarring into that muscle, which can bring about torticollis and deformity of
the cranium as the sternocleidomastoid muscle pulls on that facet of the pinnacle.
In maximum instances, positional plagiocephaly may be dealt with with a blended approach
of bodily remedy and repositioning, that is greater powerful than repositioning on my own. A
custom-outfitted cranial molding orthosis (helmet) designed to alleviate pressure at the
flattened facet have to handiest be used in th
You are seeing a 12-month-antique wholesome girl for a recurring properly care go to. Her
mom had an simple pregnancy, and the start history and newborn nursery duration had been
also without complications. She has been visible for all age-appropriate nicely child visits
and is updated on immunizations. Her boom and development have advanced generally in
view that delivery and she or he is within the fiftieth percentile for peak and weight.
Which one of the following laboratory assessments is suggested with the aid of the American
Academy of Pediatrics for habitual screening or danger evaluation at this visit?
A. A urinalysis
B. A hemoglobin or hematocrit degree
C. A serum TSH level
D. A lipid panel - ANSANSWER : B
Based on professional opinion, the American Academy of Pediatrics keeps to recommend
measuring a hemoglobin stage at one year of age. In comparison, the U.S. Preventive
Services Task Force, in a 2015 replace of their 2006 recommendation, concluded that the
modern-day evidence is inadequate to endorse for or in opposition to recurring screening for
iron deficiency anemia in youngsters 6 to 24 months of age.
A screening urinalysis isn't advocated at any age. Metabolic screening is suggested rapidly
after start to hit upon phenylketonuria, hypothyroidism, and lots of different inherited
illnesses. Screening for dyslipidemia is recommended once among nine and eleven years of
age and once between 17 and 21 years of age.
A healthful 2-month-vintage female is added on your office for a properly baby visit. Which
one of the following immunizations need to be administered at this visit?
A. Meningococcal conjugate
B. MMR
C. Oral poliovirus
D. Rotavirus - ANSANSWER : D
Childhood immunizations have avoided many previously commonplace communicable
diseases, and the CDC's Advisory Committee on Immunization Practices frequently updates
its recommendations.