sheena2005
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Posts: 257
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A healthy 8-year-old girl is brought to the
physician in July
for a well-child examination. Her mother says that
her daughter is
spending the summer at a nearby lake. Over the past
month, she has had two
episodes of painful sunburn despite her mother's
efforts, including SPF
25 sunblock just before she goes swimming and urging
her to wear a hat
and long-sleeved garments. The child takes no
medications. She has
blond hair, blue eyes, and a fair complexion. The
mother seeks advice
about preventing further sun damage to her child's
skin. Which of the
following is the most appropriate recommendation?
A
) Prohibit swimming on cloudless days
B
) Apply the sunblock lotion 45 minutes before
swimming
C
) Change to a higher-level SPF lotion
D
) Apply Burrow's solution compresses after each
overexposure
E
) Daily use of antioxidant vitamin supplement
F
) Early treatment of any sun overexposure with
topical
corticosteroids
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| sunny2
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B
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| sunny2
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Sheena, Is the answer correct !
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| sheena2005
Forum Elite
Topics: 26
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hello sunnny 2. this question is from NBMe so there is no official right or worng answer.i have ben doing a bit of search on this one.all the rest does not seem to fit in the answer, i thought of B too. but i found this online which is kinfd of confusing
"Sweating heavily, swimming, or doing other water activities reduces the SPF because sweat or water on the skin will reduce the amount of protection the sunscreen provides. Sunscreen needs to be reapplied more frequently during these activities."
i recall coming across a similar question in UW, but unfortunately my subscription has ended so can't go back and check the answer.i am regretting why didn i make notes out of it.
i hope other people join in the discussion too so that we can conclude a correct answer.
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| sheena2005
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Topics: 26
Posts: 257
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if somebody remembers the UW explanation to SPF protection please contribute here.
thanks
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| sunny2
Forum Elite
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Posts: 385
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sheena2005
I think there is no confusion to this question, the answer should be - B
They have asked us for the most appropriate recommendation
and in the question ; Look carefully - despite her mother's efforts, including SPF
25 sunblock JUST BEFORE she goes swimming
what they want to hear is the proper use of sunscreen :
and that is 45 minutes before going out in the open....be it to the swimming pool, market, golf or wherever....the sunscreen SPF takes around 20 min to 45 minutes to form a protective covering on the skin.
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| SCI.AFTAB
Forum Junior
Topics: 10
Posts: 39
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I do not know why did u pick B
THis an article in Australia, butI donot know what is exact answer for step 2(please look at 15 minutes)
Sunscreens
Sunscreens are always useful in summer and are an important adjunct to natural protection (hats & clothing) and should be applied to areas not otherwise protected. Use maximum protection SPF 15+. Apply to clean, dry skin 15 minutes before going out into the sun.
Reapply regularly, but remember that reapplication only keeps up the protection of the first application, it doesn't give you extra protection. If putting on an SPF 15+ gives you 2 hours in the sun without burning, then reapplying the sunscreen after 2 hours does not protect you for another 2 hours. You have already received a sunburn dose after the first 2 hours! Also, the UVR you get even through the sunscreen adds to your lifetime total UVR exposure and increases the risk of skin cancer.
The current Australian standard (AS/NZS 2604:1998 Sunscreen products - Evaluation and classifi-cation) limits the maximum protection claimed for sunscreen products to SPF 30+. Broad spectrum sunscreens offer protection against UVA as well as UVB. Sunscreens should be applied before going out into the sun and reapplied regularly to maintain the protection. Reapplication does not give additional protection but ensures the stated protection is achieved. For example, an SPF 15+ sunscreen that has been effectively applied will give a fair-skinned per-son about two and a half hours sun protection before they start to sunburn whilst SPF 30+ sun-screen gives about five hours sun protection.
Reapplying the sunscreen will not give extra hours of protection, but it will ensure that the sun-screen provides the full amount of protection. Application of sunscreen ineffectively or too sparingly may considerably reduce the level of protection for the wearer.
Sunscreens of less than SPF 15 offer only moderate to low protection.
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| sheena2005
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| sima
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i strongly feel answer is A,coz the child looks like phenylketonuric,or susceptible to skin cancer,recommend to avoid swimming under sun.a bit more, also any outdoor activity between 11am-4pm
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| sunny2
Forum Elite
Topics: 51
Posts: 385
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Sima,
please try listing all the points from this question which might suggest that the child looks like Phenyketonuric...you wld be surprised with the result 
blond hair , blue eyes and a fair complexion DOES NOT by itself suggest something......these type of beautiful babies are soooooo many in northamerica 
In the question they are explicitely writing that the child is 8 years old ,healthy , is on a well child exam.
may be I am wrong, and there is nothingh here to prove a point....it's just how you look at the question that changes the whole perspective
the answer A may be right as it is the closest next choice... but the logic is not correct it seems,
may be others could chip in with their views and we can reach at some common consensus
sheena , what do you think !
Edited by sunny2 on 11/09/06 - 09:04 PM. Reason: addition
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| sheena2005
Forum Elite
Topics: 26
Posts: 257
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this child is definetely not phenylketonuric, because as sunny said every other child in US has blond hair, blue eyes and a fair complexion.
A does seem like a correct choice , since she has already has sunburns, so it is better to be careful and avoid going out on cloudless days atlleast from 11 to 4 pm.
she is taking all the other necessary precautions, ie covering exposed areas etc.
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| sima
Forum Senior
Topics: 11
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thanks for correcting sunny2 ,child i snot phenyketonuric,now i also feel " C" is correct as SPF 25 sin't enough,can go to spf>30.
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| sima
Forum Senior
Topics: 11
Posts: 114
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i refered,i guess choice A is answer as best recommendation is A,sunscreens shud be apllied 15-60 min prior sunexp,it will promote more outdoor activity.hence anwer shud be "A"
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| mammyQ
Forum Newbie
Topics: 5
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I think C is the answer cos lighter skin needs higher sun protective factor SPF
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| ed222
Forum Senior
Topics: 4
Posts: 147
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I think the closes answer is B. Applied ahead of time so it reabsorb and protects and just doesnot washed easily
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| docrao5
Forum Junior
Topics: 8
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pls label ur question as nbme if it is.. so that people will know to avoid it if they have`nt done nbme yet. thank you
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| sheena2005
Forum Elite
Topics: 26
Posts: 257
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ok dacrao, i m sorry about that....
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| new_n_lost
Forum Hero
Topics: 724
Posts: 6,388
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the Choice B is the only logical answer here i guess cos she is having her first episode as such n if she was Phenylketouric then there wudnt be a 2 episodes there wud be more now the mother is doing wht she can to prevent it now they only specifed one thing here either abt eh Girl previous history or Sunblock n ht eonly reference is to the Sunblock Application so hence we have to assume logically that she isnt applying the Suncreen properly
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| AAAAA
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sheena2005 wrote:
this child is definetely not phenylketonuric, because as sunny said every other child in US has blond hair, blue eyes and a fair complexion.
A does seem like a correct choice , since she has already has sunburns, so it is better to be careful and avoid going out on cloudless days atlleast from 11 to 4 pm.
she is taking all the other necessary precautions, ie covering exposed areas etc.
Only around 28% of all children may be blond or dirty blond and their hair color darkens as they grow older.
So around 1 out of 4 are blond when they were born !
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| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
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sheena2005 wrote:
A healthy 8-year-old girl is brought to the
physician in July
for a well-child examination. Her mother says that
her daughter is
spending the summer at a nearby lake. Over the past
month, she has had two
episodes of painful sunburn despite her mother's
efforts, including SPF
25 sunblock just before she goes swimming and urging
her to wear a hat
and long-sleeved garments. The child takes no
medications. She has
blond hair, blue eyes, and a fair complexion. The
mother seeks advice
about preventing further sun damage to her child's
skin. Which of the
following is the most appropriate recommendation?
A
) Prohibit swimming on cloudless days
B
) Apply the sunblock lotion 45 minutes before
swimming
C
) Change to a higher-level SPF lotion
D
) Apply Burrow's solution compresses after each
overexposure
E
) Daily use of antioxidant vitamin supplement
F
) Early treatment of any sun overexposure with
topical
corticosteroids
NMBE wants to raise the awareness of melanoma in early childhood.
The number 1 risk factor of developing the most deadly disease is melanoma and the highest risk is early exposure to sun. So the proper way to do this is to use sunblock greater than 15 and apply 45 mnutes before going to swimming !
___________________
seeking study partner in USMLE, Canadian MCC OSCE examination
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