macintosh
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Topics: 38
Posts: 178
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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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| macintosh
Forum Elite
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Do not have the slightest idea about this. Please explain when you write your answer.
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| Tiff
Forum Guru
Topics: 54
Posts: 563
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Spf 25 is relatively low. Spf 30 is low. Children generally need a higher spf sunblock like spf 45. So I'd go with Choice C - change to a higher level spf lotion.
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| maoudoody
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b:
sunblocks should be applied 30 - 60 minutes before exposure to sun
and the question says the mother applied it " just before" going swimming
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| macintosh
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Posts: 178
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Dear Tiff may you please refer the literature regarding the SPF dose for children. I think maoudoody is right, as the sunblock would wear off if applied just before swimming. It is even recommended to reapply sunblock after swimming, so b might be correct.
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| Tiff
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Posts: 563
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Hi. Don't really have documentation. Just going by what I've learned. But here's something I found. http://www.uhs.berkeley.edu/home/healthtopics/sun...
"You may want to use a higher SPF if you are very sun-sensitive or are taking a drug that makes you burn more readily, such as tetracycline, a sulfonamide or a thiazide diuretic. Children need an SPF value of 30 to 45, since they spend more of their time in the sun. It is estimated that 80% of one's lifetime sun exposure occurs in childhood. "
I didn't go for choice B becuase sunscreen should be applied 15-30 minutes prior. Haven't realy heard about applying it an hour prior. Could be wrong though. THought it wouldn't make sense because the longer you have it on the less protection it would provide and the more it wears off and it's something that has to be reapplied and that's a concern in children. - having it wear off. If there was a choice that said to apply before and after swimming, i would've chosen that. Also the way the girl is described implies that she would be sensitive in the sun. But that's just what I thought.
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| macintosh
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Thank you for your input Tiff.
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| maoudoody
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so wats the correct ans?
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| macintosh
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Topics: 38
Posts: 178
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whatever you think is correct is the correct answer. Alternatively we can contact the NBME to provide us with an answer key to its questions.
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