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The mother of a 2-year-old girl brings her daughter to her pediatrician for her recommended well-child check-up. Currently the child seems perfectly healthy. She is feeding and sleeping well and is taking no medications. The mother™s pregnancy was uncomplicated and all prenatal screening tests were normal. The child was delivered at 40 weeks gestation. Birth weight was 7 lbs, 12 oz and length 19 inches. One and 5 minute American pediatric gross assessment record (APGAR) scores were 7 and 8. She had mild detectable jaundice to the level of her sternal notch that resolved after 1 week including 1 day of phototherapy in the newborn unit. She has experienced two self limiting illnesses consistent with viral exanthemas of childhood and one episode of otitis media, successfully treated with a 10-day course of amoxicillin 6 months ago. All recommended screening tests have been negative on previous visits and immunizations are current as of the last visit 3 months ago. Weight is 21 lbs and length 29 inches. Vital signs are temperature (oral) 37.6°C (99.7° F), blood pressure (BP) 95/62 mm Hg, heart rate 120 beats minute, respiration rate 30 breaths/minute.

Item 3 of 3

As indicated previously, the child has received all recommended screening tests for ages 0 to 9 months. What screening tests are appropriate at this time?



A. Complete blood count (CBC), blood lead level, HgB electrophoresis and purified protein derivative (PPD)

B. Serum blood urea nitrogen (BUN), creatinine, and blood glucose

C. Serum BUN, creatinine, total and direct bilirubin and CBC with peripheral smear

D. Thyroid-stimulating hormone (TSH), blood lead level and phenylketonuria (PKU) screen

E. TSH, CBC, and PPD

it is confusing, you are right!
but i give it a try aa.

hmmmmmm... i ll go with C

PPD is not recommended for the person at low TB risk , PKU screening was done at materinity ,glucose screening is performed in obese children with 2 risk factor for DM at 10 y/o age. By deduction the answer is C