Treating the baby of a Hepatitis B Positive Mother - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 10-01-2011
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 515
Threads: 88
Thanked 507 Times in 232 Posts
Reputation: 517
Virus Treating the baby of a Hepatitis B Positive Mother

A baby, born in the hospital, mother was hepatitis B surface Ag positive. What is the best management of this bay?
  • First dose of hepatitis B vaccine before discharge + hepatitis B Ig, second dose of the vaccine at one to two month latter, the 3rd dose of the vaccine 6 to 18 months from the first dose.
  • First dose of hepatitis B vaccine with 12 Hrs of birth + hepatitis B Ig, second dose of the vaccine at one month latter, the 3rd dose of the vaccine at 6 from the first dose.
  • First dose of hepatitis B vaccine with 12 Hrs of birth, the second dose of the vaccine at one month latter, the 3rd dose of the vaccine at 6 from the first dose.
  • First of the vaccine should be given soon after birth, with total doses of 3 given by the age of 18 month.
Reply With Quote Quick reply to this message
The above post was thanked by:
Ace3 (10-16-2011), busterbee (10-01-2011), dryogi (10-01-2011), step1an (10-02-2011)



  #2  
Old 10-01-2011
busterbee's Avatar
USMLE Forums Veteran
 
Steps History: 1 + CK
Posts: 218
Threads: 16
Thanked 110 Times in 59 Posts
Reputation: 120
Default

First dose of hepatitis B vaccine with 12 Hrs of birth + hepatitis B Ig, second dose of the vaccine at one month latter, the 3rd dose of the vaccine at 6 from the first dose.
__________________
you are born with wings, don't walk through life
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message
The above post was thanked by:
dryogi (10-01-2011), step1an (10-02-2011)
  #3  
Old 10-01-2011
dr_mhm's Avatar
USMLE Forums Guru
 
Steps History: 1+CK+CS
Posts: 460
Threads: 100
Thanked 235 Times in 147 Posts
Reputation: 245
Default

Agree with busterbee!
Reply With Quote Quick reply to this message
The above post was thanked by:
busterbee (10-01-2011)
 
  #4  
Old 10-01-2011
USMLE Forums Addict
 
Steps History: 1+CK+CS+3
Posts: 137
Threads: 26
Thanked 158 Times in 46 Posts
Reputation: 168
Default

Agree with busterbee as well!
Reply With Quote Quick reply to this message
The above post was thanked by:
busterbee (10-01-2011)
  #5  
Old 10-02-2011
Aussie Guy's Avatar
USMLE Forums Scout
 
Steps History: 1+CK+CS
Posts: 40
Threads: 2
Thanked 20 Times in 15 Posts
Reputation: 30
Smile

Quote:
Originally Posted by ag2011n View Post
A baby, born in the hospital, mother was hepatitis B surface Ag positive. What is the best management of this bay?
  • First dose of hepatitis B vaccine before discharge + hepatitis B Ig, second dose of the vaccine at one to two month latter, the 3rd dose of the vaccine 6 to 18 months from the first dose.
  • First dose of hepatitis B vaccine with 12 Hrs of birth + hepatitis B Ig, second dose of the vaccine at one month latter, the 3rd dose of the vaccine at 6 from the first dose.
  • First dose of hepatitis B vaccine with 12 Hrs of birth, the second dose of the vaccine at one month latter, the 3rd dose of the vaccine at 6 from the first dose.
  • First of the vaccine should be given soon after birth, with total doses of 3 given by the age of 18 month.
CDC guidelines are
Administer HBIG* + single-antigen hepatitis B vaccine within 12 hrs of birth.
Do not count the birth dose as part of the vaccine series.
Administer 3 additional hepatitis B vaccine doses with
- single-antigen vaccine at ages 1, 23, and 6 mos, or
- hepatitis B-containing combination vaccine at ages 2, 4, and 6 mos
(Pediarix) or 2, 4, and 1215 mos (Comvax).

Test for HBsAg and antibody to HBsAg 12 mos after completion of
> 3 doses of a licensed hepatitis B vaccine series (i.e., at age 918 mos,
generally at the next well-child visit). Testing should not be performed
before age 9 mos nor within 4 wks of the most recent vaccine dose
__________________
Life is living on the edge...so watch out your every step
Reply With Quote Quick reply to this message
The above post was thanked by:
ag2011n (10-02-2011), SHICE (10-02-2011), step1an (10-02-2011)
  #6  
Old 10-02-2011
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 515
Threads: 88
Thanked 507 Times in 232 Posts
Reputation: 517
Default

The correct answer is:
First dose of hepatitis B vaccine with 12 Hrs of birth + hepatitis B Ig, second dose of the vaccine at one month latter, the 3rd dose of the vaccine at 6 from the first dose.
You need to treat same as exposure.
Reply With Quote Quick reply to this message
  #7  
Old 10-02-2011
USMLE Forums Addict
 
Steps History: 1+CK+CS+3
Posts: 137
Threads: 26
Thanked 158 Times in 46 Posts
Reputation: 168
Default

Quote:
Originally Posted by Aussie Guy View Post
CDC guidelines are
Administer HBIG* + single-antigen hepatitis B vaccine within 12 hrs of birth.
• Do not count the birth dose as part of the vaccine series.
• Administer 3 additional hepatitis B vaccine doses with
- single-antigen vaccine at ages 1, 2–3, and 6 mos, or
- hepatitis B-containing combination vaccine at ages 2, 4, and 6 mos
(Pediarix) or 2, 4, and 12–15 mos (Comvax).

• Test for HBsAg and antibody to HBsAg 1–2 mos after completion of
> 3 doses of a licensed hepatitis B vaccine series (i.e., at age 9–18 mos,
generally at the next well-child visit). Testing should not be performed
before age 9 mos nor within 4 wks of the most recent vaccine dose
Very useful..thanks a ton for such a detailed response..!
Reply With Quote Quick reply to this message
The above post was thanked by:
Aussie Guy (10-02-2011)
  #8  
Old 10-15-2011
Ace3's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 735
Threads: 89
Thanked 289 Times in 191 Posts
Reputation: 301
Default

As neonate born to Hepb suface ag positive should not be breast feed untill baby is vaccinated and ig is given so it should be given immimdiatly after birth as we have to start nursing baby ...so if guidelines states with in 12 hrs we cannot wait for that to start nursing baby...so it should be immidiatly rightafter birth so why answer is not soon after birth that is last choice in q above???
Reply With Quote Quick reply to this message
  #9  
Old 10-15-2011
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 515
Threads: 88
Thanked 507 Times in 232 Posts
Reputation: 517
Default

Hepatitis B positive mother can breast feed her baby even before the availability of hepatitis B vaccine, HBV transmission through breastfeeding was not reported, this is according to CDC.
This is the link
http://www.cdc.gov/breastfeeding/disease/hepatitis.htm
Reply With Quote Quick reply to this message
The above post was thanked by:
Ace3 (10-16-2011), anatomie (10-16-2011)
  #10  
Old 10-16-2011
Ace3's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 735
Threads: 89
Thanked 289 Times in 191 Posts
Reputation: 301
Default

Quote:
Originally Posted by ag2011n View Post
Hepatitis B positive mother can breast feed her baby even before the availability of hepatitis B vaccine, HBV transmission through breastfeeding was not reported, this is according to CDC.
This is the link
http://www.cdc.gov/breastfeeding/disease/hepatitis.htm
Yes but kaplan pg 66 in obs say that baby nursing can be started once it has been given vaccine and igG. MTB 3 page no 393 says breastfeeding is contraindicated in hep b before infant is immunized. So which one to follow for exam??
Reply With Quote Quick reply to this message
  #11  
Old 10-16-2011
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 515
Threads: 88
Thanked 507 Times in 232 Posts
Reputation: 517
Default

You are right this confusing, I believe we suppose to follow CDC, but, let hear form the other fellows.
Reply With Quote Quick reply to this message
  #12  
Old 10-16-2011
USMLE Forums Scout
 
Steps History: 1+CK+CS
Posts: 67
Threads: 24
Thanked 18 Times in 12 Posts
Reputation: 28
Default

Quote:
Originally Posted by ag2011n View Post
Hepatitis B positive mother can breast feed her baby even before the availability of hepatitis B vaccine, HBV transmission through breastfeeding was not reported, this is according to CDC.
This is the link
http://www.cdc.gov/breastfeeding/disease/hepatitis.htm

Thanks for your post....this will clear the dilema about this topic.

In MTB for step 3 there is contraindication for breastfeed if mother has hepatitis B....MTb says you she can breastfeed after the baby receive his/her immunization(vaccine and Ig); I am doing an offline qbank and I got a question with this scenario(here is the post: Hepatitis B Positive Mom feeding her newborn! everything is clear and unfortunatelly MTB is wrong. Thanks one more time for your post!
Reply With Quote Quick reply to this message
  #13  
Old 10-16-2011
Ace3's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 735
Threads: 89
Thanked 289 Times in 191 Posts
Reputation: 301
Default

Quote:
Originally Posted by anatomie View Post
Thanks for your post....this will clear the dilema about this topic.

In MTB for step 3 there is contraindication for breastfeed if mother has hepatitis B....MTb says you she can breastfeed after the baby receive his/her immunization(vaccine and Ig); I am doing an offline qbank and I got a question with this scenario(here is the post: Hepatitis B Positive Mom feeding her newborn! everything is clear and unfortunatelly MTB is wrong. Thanks one more time for your post!
hey that link is deleted so can you please share the answer that you read.......thanks
Reply With Quote Quick reply to this message
  #14  
Old 10-16-2011
USMLE Forums Scout
 
Steps History: 1+CK+CS
Posts: 67
Threads: 24
Thanked 18 Times in 12 Posts
Reputation: 28
Default

Quote:
Originally Posted by confident View Post
hey that link is deleted so can you please share the answer that you read.......thanks

this was my original post:

You get a call from a pregnant hepatitis B surface antigen positive woman that you have been taking care of. She is frantic because she unexpectedly went into labor and delivered the baby in her bathtub 30 minutes earlier. She had her husband cut the cord with a clean kitchen knife and the baby appears to be doing well. She wants to know if you can see her immediately. She is concerned about how her hepatitis status affects breast-feeding. You tell her to bring the baby over to the office and

A. not to breast-feed until the baby received the proper immunizations
B. that she can begin to breast-feed immediately if the baby is hungry
C. that her newborn will need to be treated with alpha interferon
D. that her breast milk does not contain hepatitis B surface antigen
E. that she should not breast-feed the newborn because of her hepatitis status



on MTB for step 3, at page 393, there is a chart with breat feed contraindication....it says if mother has infection with HIV, active TB, HEPATITIS B BEFORE THE BABY IS IMMUNIZED, etc, breastfeeding is contraindicated; I choose answer A....the right answer is given as B and this is the explanation: 'The correct answer is B. Even though the breast milk from a hepatitis B surface antigen positive woman contains the hepatitis B surface antigen, according to the American Academy of Pediatrics and the Report of the Committee on Infectious Diseases, breast-feeding does not significantly increase the risk of infection. Newborns born to HBsAg positive women should be given the hepatitis B vaccine and hepatitis B immune globulin as soon after birth as possible, but breast-feeding does not need to be delayed until after immunizations. Therefore, she should be advised that she can begin to breast-feed immediately if the baby is hungry.

As stated above, it is not necessary to wait to breast-feed until after the baby is immunized. Therefore, telling her not to breast-feed until after the baby receives the proper immunizations is incorrect(choice A).'
Reply With Quote Quick reply to this message
  #15  
Old 10-16-2011
Ace3's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 735
Threads: 89
Thanked 289 Times in 191 Posts
Reputation: 301
Default

Quote:
Originally Posted by anatomie View Post
this was my original post:

You get a call from a pregnant hepatitis B surface antigen positive woman that you have been taking care of. She is frantic because she unexpectedly went into labor and delivered the baby in her bathtub 30 minutes earlier. She had her husband cut the cord with a clean kitchen knife and the baby appears to be doing well. She wants to know if you can see her immediately. She is concerned about how her hepatitis status affects breast-feeding. You tell her to bring the baby over to the office and

A. not to breast-feed until the baby received the proper immunizations
B. that she can begin to breast-feed immediately if the baby is hungry
C. that her newborn will need to be treated with alpha interferon
D. that her breast milk does not contain hepatitis B surface antigen
E. that she should not breast-feed the newborn because of her hepatitis status



on MTB for step 3, at page 393, there is a chart with breat feed contraindication....it says if mother has infection with HIV, active TB, HEPATITIS B BEFORE THE BABY IS IMMUNIZED, etc, breastfeeding is contraindicated; I choose answer A....the right answer is given as B and this is the explanation: 'The correct answer is B. Even though the breast milk from a hepatitis B surface antigen positive woman contains the hepatitis B surface antigen, according to the American Academy of Pediatrics and the Report of the Committee on Infectious Diseases, breast-feeding does not significantly increase the risk of infection. Newborns born to HBsAg positive women should be given the hepatitis B vaccine and hepatitis B immune globulin as soon after birth as possible, but breast-feeding does not need to be delayed until after immunizations. Therefore, she should be advised that she can begin to breast-feed immediately if the baby is hungry.

As stated above, it is not necessary to wait to breast-feed until after the baby is immunized. Therefore, telling her not to breast-feed until after the baby receives the proper immunizations is incorrect(choice A).'

ok thanks for the post....i saw this one earlier....can you please tell what is the source of q...so it will help to decide how much to relay on explanation...thanks
Reply With Quote Quick reply to this message



  #16  
Old 10-16-2011
USMLE Forums Scout
 
Steps History: 1+CK+CS
Posts: 67
Threads: 24
Thanked 18 Times in 12 Posts
Reputation: 28
Default

Quote:
Originally Posted by confident View Post
ok thanks for the post....i saw this one earlier....can you please tell what is the source of q...so it will help to decide how much to relay on explanation...thanks

I am sorry but I can't help you....A little while ago I was looking for some offline qbanks for step 3 and somebody recommand this qbank called 'MCQ's for step 3'; I have no ideea what year nor the origin of the question bank;
Reply With Quote Quick reply to this message
The above post was thanked by:
Ace3 (10-16-2011)



Reply

Tags
Infectious-Diseases, Pediatrics-, Step-2-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Female baby born to hepatitis B positive mom aksyonez USMLE Step 2 CK Forum 4 07-02-2011 06:31 PM
When do we start treating hepatitis? docoftheworld USMLE Step 2 CK Forum 1 05-31-2011 03:32 PM
The mother of TGA baby! tinhi USMLE Step 1 Forum 9 04-04-2011 07:17 PM
Rh negative Mom-Rh positive Baby aktorque USMLE Step 1 Forum 24 02-23-2011 08:53 AM
Newborn Mother Baby Bonding dranant USMLE Step 1 Forum 5 08-23-2010 02:15 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)