USMLE-Rx Step 2 Qmax Challenge #21156

Check out today’s Step 2 CK Qmax Question Challenge.

Know the answer? Post it in the comments below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

A 32-hour-old Caucasian male infant has worsening jaundice and is brought to the emergency department by his parents. They state he has been sucking at the nipple less vigorously, and is harder to awaken. He was born at home to a 31-year-old G2P1 woman at 38 weeks’ gestation by vaginal delivery after an uncomplicated pregnancy. Maternal serology results indicate she is HIV negative, hepatitis B immunized, rubella immunized, and blood type O-positive. The infant is 3100 g (6.8 lb) and afebrile and lethargic but arousable. His physical examination is notable for jaundice including the palms and soles, hypotonia, and a high-pitched cry. Laboratory tests show a total bilirubin level of 26 mg/dL. A Coombs’ test is positive. He is admitted to the neonatal intensive care unit, where appropriate therapy is initiated and the bilirubin level drops to 13 mg/dL within 6 hours.

Which of the following is a possible complication of the therapy he most likely received in the neonatal intensive care unit?

A. Anemia
B. Bleeding
C. Decreased hearing
D. Pneumothorax
E. Poor bone growth


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17 thoughts on “USMLE-Rx Step 2 Qmax Challenge #21156”

    1. baby may have received exchange transfusion so complication of acute transfusion is bleeding.

  1. I don’t think so BT complications including bleeding if there is negative H/O trauma.
    BT complications include Haemolysis

  2. (A)nemia

    ABO hemolytic disease of the newborn. Photo-therapy, IVIG, exchange transfusions.

    not sure, but I will go for anemia.

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