ABFM Care of Children Exam 2025
With 100% Correct Answers
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 - CORRECT 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 - CORRECT 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" - CORRECT 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.
Children may hold their head in an abnormal position if they have severe esotropia, creating
either real or perceived changes in skull growth.
With 100% Correct Answers
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 - CORRECT 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 - CORRECT 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" - CORRECT 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.
Children may hold their head in an abnormal position if they have severe esotropia, creating
either real or perceived changes in skull growth.
