A 12-month-old girl is brought to her pediatrician for a checkup and vaccines. The patient’s mother wants to send her to daycare but is worried about exposure to unvaccinated children and other potential sources of infection. The toddler was born at 39 weeks gestation via spontaneous vaginal delivery. She is up to date on all vaccines. She does not walk yet but stands in place and can say a few words. The toddler drinks formula and eats a mixture of soft vegetables and pureed meals. She has no current medications. On physical exam, the vital signs include: temperature 37.0°C (98.6°F), blood pressure 95/50 mm Hg, pulse 130/min, and respiratory rate 28/min. The patient is alert and responsive. The remainder of the exam is unremarkable. Which of the following is most appropriate for this patient at this visit?
AMeningococcal vaccine
BGross motor workup and evaluation
CRotavirus vaccine
DReferral for speech pathology
EMMR vaccine
A 12-month-old boy presents for a routine checkup. The patient immigrated from the Philippines with his parents a few months ago. No prior immunization records are available. The patient’s mother claims that he had a series of shots at 6 months of age which gave him a severe allergic reaction with swelling of the tongue and the face. She also remembers that he had the same reaction when she introduced solid foods to his diet, including carrots, eggs, and bananas. Which of the following vaccinations are not recommended for this patient?
AMeasles, mumps, and rubella (MMR) vaccine
BHepatitis B vaccine
CVaricella vaccine
DIntranasal influenza vaccine
EIntramuscular influenza vaccine
An 11-month-old boy is brought to a pediatrician by his parents for evaluation of vomiting and watery diarrhea over the last day. The mother informs the pediatrician that the boy had consumed an apple bought from a fruit vendor on the previous day, but that otherwise there has been no recent change in his diet. There is no history of blood in the stool, flatulence, irritability, or poor appetite. There is no history of recurrent or chronic diarrhea or any other gastrointestinal symptoms. On physical examination, his temperature is 37.6°C (99.6°F), pulse is 120/min, respirations are 24/min, and blood pressure is 92/60 mm Hg. General examination reveals a playful infant with normal skin turgor and no sunken eyes. The pediatrician explains to the parents that he most likely has acute gastroenteritis and that no specific medication is indicated at present. He also instructs the parents about his diet during the illness and reviews the danger signs of dehydration. He suggests a follow-up evaluation after 48 hours or earlier if any complications arise. Which of the following dietary recommendations did the pediatrician make?
APlenty of juices and carbonated sodas
BAge-appropriate diet
CDiluted formula milk
DLactose-free diet
EBRAT diet
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