9 month in well baby clinic...reassure her or not ? - USMLE Forums
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  #1  
Old 06-19-2012
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Kids 9 month in well baby clinic...reassure her or not ?

A 9-month-old child comes in for a routine visit. She has had several episodes of otitis media in the past, but
no major illnesses or hospitalizations. Her mother is concerned because the child w as previously happy and
social around other people, but now cries if her mother is not in the room. The child constantly w ants to be
held by her mother and becomes upset if her mother walks into the next room. Her grandmother keeps her
during the day , and she now cries when her mother leaves her in the morning. Developmentally , she is
crawling and w aves bye-bye. She does not yet respond to her name or say words. She previously babbled
but stopped several months ago. W hen you hide a toy with your hand, she lifts your hand to look for the
toy W hich of the following is the best next step in the management of this child?
A. Psychological evaluation
B. Audiology evaluation
C. Physical therapy evaluation
D. Social services referral
E. Reassure the mother that the child's development is normal.
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  #2  
Old 06-20-2012
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Post separation anxiety.

awnser should be E.
becoz it is separation anxiety

As infants develop, they experience various emotions, usually in a predictable order. Before 8 months, infants are so new to the world that they have little knowledge of what is ordinary and what may be dangerous, so new situations or experiences seem usual, and not frightening.

In normal development, during this early period the infant becomes familiar with the home environment, and feels comfortable when parents or other known caretakers are present. After this time, lack of familiarity often produces fear because the infant recognizes that something unusual is going on.

From 8 to 15 months, children often become frightened when they meet new people or visit new places. They recognize their parents as familiar and safe. When separated from their parents, particularly when away from home, they feel threatened and unsafe.

It usually ends when the child is around 2 years old. At this age, toddlers begin to understand that parents may be out of sight now, but will return later.
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  #3  
Old 06-21-2012
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i don't agree with ur answer...:::
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  #4  
Old 06-21-2012
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I think B...?
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  #5  
Old 06-21-2012
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Quote:
Originally Posted by add1 View Post
i don't agree with ur answer...:::
I don't think that's a choice on the exam.
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  #6  
Old 06-21-2012
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Quote:
Originally Posted by Novobiocin View Post
I don't think that's a choice on the exam.

Its B...... mbbs2010 solved it in a thread above , several episodes of otitis media and the child has stopped talking so ...... ans B
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  #7  
Old 06-21-2012
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Quote:
Originally Posted by add1 View Post
i don't agree with ur answer...:::
oh i miss the above part of question
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  #8  
Old 06-21-2012
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She previously babbled
but stopped several months ago and recurrent history of otitis media=
the child needs audiology evaluation
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  #9  
Old 06-22-2012
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I agree she needs audiology evaluation, maybe she just developed otosclerosis or a coloboma ?
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  #10  
Old 06-23-2012
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B. Audiology evaluation


this q in kaplan bank
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  #11  
Old 06-23-2012
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Quote:
Originally Posted by XpaezX View Post
I agree she needs audiology evaluation, maybe she just developed otosclerosis or a coloboma ?
Coloboma is in the eye.:sorry:

Quote:
A 9-month-old child comes in for a routine visit. She has had several episodes of otitis media in the past, but no major illnesses or hospitalizations. Her mother is concerned because the child w as previously happy and
social around other people, but now cries if her mother is not in the room. The child constantly w ants to be held by her mother and becomes upset if her mother walks into the next room. Her grandmother keeps her during the day , and she now cries when her mother leaves her in the morning. Developmentally , she is crawling and w aves bye-bye. She does not yet respond to her name or say words. She previously babbled but stopped several months ago. W hen you hide a toy with your hand, she lifts your hand to look for the toy W hich of the following is the best next step in the management of this child?
She does not yet respond to her name or say words>>>>At 9 months she should do that so the possibility of deafness is high especially in the setting of recurrent OM.

She previously babbled but stopped several months ago>>>> Even more worrying for deafness since in order to develop language skills the child need to hear.
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