NBME 4

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Prep4USMLE Forum » USMLE Step 2 CK Forum » Pediatrics Forum

NBME 4

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9 Posts

dr_jojo

03/14/07 - 10:35 AM

13.

A 7-day-old newborn is brought for a well-child examination. He was born at home. His mother has taken acetaminophen for perineal discomfort. The newborn is breast-feeding well. He is at the 75th percentile for length and weight. Examination shows no abnormalities. After vaccination with hepatitis B, he has prolonged bleeding at the injection site. There is no family history of excessive bleeding. Laboratory studies show:

Hemoglobin 16 g/dL
Leukocyte count 6800/mm3
Segmented neutrophils 48%
Bands 2%
Lymphocytes 50%
Platelet count 280,000/mm3
Prothrombin time 20 sec (INR=1.6)
Partial thromboplastin time 60 sec

Which of the following is the most likely mechanism for these findings?

A
) Autoimmunization

B
) Bacterial toxic effect

C
) Factor VIII deficiency

D
) Factor IX deficiency

E
) Immunoglobulin deficiency

F
) Iron deficiency

G
) Pharmacologic effect

H
) Viral toxic effect

I
) Vitamin deficiency

J
) Zinc deficiency

robin082006
Forum Hero
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Topics: 471
Posts: 5,125

03/14/07 - 10:44 AM

I
) Vitamin deficiency

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dr_jojo

03/14/07 - 11:07 AM

zeloc
Forum Junior

Topics: 11
Posts: 53

08/20/07 - 08:36 PM

Why is the answer vitamin deficiency?

zeloc
Forum Junior

Topics: 11
Posts: 53

08/20/07 - 08:46 PM

Nevermind. I missed the 2 clues in the question: no history of excessive bleeding in the family (not Hemophilia) and the baby was born at home (no vitamin K injection).

liliaeliz
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