A 7-day-old male infant presents to the pediatrician for weight loss. There is no history of excessive crying, irritability, lethargy, or feeding difficulty. The parents deny any history of fast breathing, bluish discoloration of lips/nails, fever, vomiting, diarrhea, or seizures. He was born at full term by vaginal delivery without any perinatal complications and his birth weight was 3.6 kg (8 lb). Since birth he has been exclusively breastfed and passes urine six to eight times a day. His physical examination, including vital signs, is completely normal. His weight is 3.3 kg (7.3 lb); length and head circumference are normal for his age and sex. Which of the following is the next best step in the management of the infant?
AReassurance of parents
BEvaluation of the mother for malnutrition
CAdmission of the infant in the NICU to treat with empiric intravenous antibiotics
DEmphasize the need to clothe the infant warmly to prevent hypothermia
ESupplementation of breastfeeding with an appropriate infant formula
A first time mother of a healthy, full term, newborn girl is anxious about sudden infant death syndrome. Which of the following pieces of advice can reduce the risk of SIDS?
ASleep supine in a crib with bumpers, head propped up on a pillow, and wrapped in a warm blanket
BSleep supine in a crib with bumpers, head propped up on a pillow, and wrapped in an infant sleeper
CSleep supine in the parent's bed and use a pacifier after 1 month of age
DSleep supine in a crib without bumpers, use a pacifier after 1 month of age, and use a home apnea monitor
ESleep supine in a crib without bumpers, use a pacifier after 1 month of age, and avoid smoking
An infant boy of unknown age and medical history is dropped off in the emergency department. The infant appears lethargic and has a large protruding tongue. Although the infant exhibits signs of neglect, he is in no apparent distress. The heart rate is 70/min, the respiratory rate is 30/min, and the temperature is 35.7°C (96.2°F). Which of the following is the most likely cause of the patient’s physical exam findings?
AAutosomal dominant mutation in the SERPING1 gene
BGenetic imprinting disorder affecting chromosome 11p15.5
CType I hypersensitivity reaction
DExcess growth hormone secondary to pituitary gland tumor
ECongenital agenesis of an endocrine gland in the anterior neck
+ 7 more in the PDF
Browse all chapters