Sunday - April 20, 2025

What is the first step in managing choking in an infant under 1 year old?

• Perform the Heimlich maneuver

• Give back blows

• Perform chest compressions

• Call emergency services immediately

Answer explanation

What is the most common initial management approach for a baby diagnosed with cow's milk protein allergy (CMPA)?

• Starting a hypoallergenic formula or amino acid-based formula

• Adding solid foods to the baby’s diet

• Prescribing antibiotics to prevent infections

• Recommending breastfeeding with cow's milk-based supplements

Answer explanation

The most common initial management approach for CMPA is to remove the cow's milk protein from the baby’s diet and switch to a hypoallergenic formula or amino acid-based formula. Antibiotics: Not used as it's an allergic reaction.

Breast milk may still contain traces of cow's milk protein, potentially triggering an allergic reaction.

What is the recommended formula for a baby with a moderate to severe cow’s milk protein allergy?

• Soy-based formula

• Cow's milk-based formula

• Hydrolyzed formula (partially or extensively hydrolyzed)

• Lactose-free formula

Answer explanation

The recommended formula is a hydrolyzed formula as they break down cow's milk proteins into smaller, less allergenic components, reducing the likelihood of an allergic reaction. There are two types: Partially and extensively hydrolyzed formulas suited for mild and moderate cow milk protein allergy respectively.

Soy-based formula: Not the first choice; may cause reactions in babies allergic to soy.

Lactose-free formula: Meant for lactose intolerance, not CMPA; doesn't remove milk proteins.

At what age should autism screening typically begin in primary care settings, according to current guidelines?

• 3 months
  
  

• 6 months
  
  

• 24 months
  
  

• 5 years

Answer explanation

According to the World Health Organization (WHO) growth standards, a 12-month-old infant typically weighs around:

• 7-8 kg

• 9-10 kg

• 11-12 kg

• 13-14 kg

Answer explanation

Formula in ages 1- 5 years  estimated weight (age in years + 5 ) x 2

Age < 1 year .. ( age in months + 9 ) / 2

What is the key consideration when administering vaccines to premature infants?

• Vaccines should be delayed until the baby reaches full-term age

• Immunization should follow the standard schedule based on the infant’s actual age

• Vaccines should only be given if the baby is in the NICU for an extended period

• Premature infants should not receive any live vaccines

Answer explanation

Premature infants are vaccinated based on their chronological (actual) age, not corrected age, to ensure timely protection against infections.

Global developmental delay implies:

• Delay in only gross motor skills

• Delay in at least one developmental domain

• Delay in two or more developmental domains

• Delay in physical growth only

Answer explanation

Global developmental delay is diagnosed when a child shows significant delays in at least two of the following: gross/fine motor, speech/language, cognitive, social, or daily living skills.

Which of the following is most concerning for an underlying neurological disorder?

• Delay in walking

• Delay in speech

• Regression of previously acquired language and motor skills

• Variation in milestone acquisition between gross and fine motor

Answer explanation

Regression is the red flag among developmental concerns. Losing previously acquired milestones may point to neurological or metabolic disorders

A 24-months-old child who has not been previously vaccinated comes to you for general health checkup. Which vaccines are not advised for catch up immunization?

• BCG

• OPV

• Rota virus

• IPV

• Hep B

Answer explanation

The CDC recommends that infants who have missed the scheduled rotavirus vaccination should receive a catch-up vaccination series as soon as possible, but no later than 8 months of age. The rotavirus vaccine is not recommended after a certain age because of the risk of intussusception