ABFM KSA Care of Hospitalized Patients Exam Package
with Solution Updated 2026/2027 ABFM ITE Final Exam
Study Resource for Family Medicine Certification
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 HBsAg
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.
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.
with Solution Updated 2026/2027 ABFM ITE Final Exam
Study Resource for Family Medicine Certification
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 HBsAg
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.
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.
