A healthy 30-year-old at 33 weeks' gestation presents for routine prenatal care in late September in the northeast USA. She's not previously received any vaccines. And about the past ten years and states, "I heard there are shots to protect the baby from RSV. My niece had this when she was a month old and got very sick".

Which of the following is the best response?

A. Recommend a single dose of an FDA approved RSV vaccine as soon as possible.

B. The maternal RSV vaccine is recommended with each pregnancy, preferably given in the first trimester.

C. Given that her baby will be born outside of the typical RSV season, the use of maternal RSV vaccine is not recommended.

D. The maternal RSV vaccine is given to provide protection to the mother but not the baby.

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YouTube: https://www.youtube.com/watch?v=_W6PE873iKQ&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=159

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A 12-year-old male presents with his father for a routine Whelchel visit. The father asked to speak to you privately, as he's concerned that his son is, quote, showing some body changes. Close quote during the visit, the child is alert, interactive with physical exam findings consistent with Tanner's Stage three sexual maturation. He remains on his growth curve for height and weight.

When discussing these findings with the father, which of the following is the most accurate statement?

A. These findings are normal for his age.

B. This is an unusual finding in a 12-year-old.

C. This signals he is likely nearly his adult height.

D. He just started puberty changes.

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YouTube: https://www.youtube.com/watch?v=OtJ8LiFErYA&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=158

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A seven year old with a diagnosis of asthma since age to present with his parents for a new patient visit. He has cough, wheezing and shortness of breath 4 to 5 days per week and awakens with asthma symptoms about once weekly. His parents states when he's playing soccer, sometimes he needs to stop running because of his cough. So last visit with his prior PCP was about seven months ago when he was prescribed, according to his parents quote, "a pill to take every day to help control his cough". His last dose of this medication was about two months ago because the medication had no refills.

He's currently using albuterol as needed. Two puffs, about 3 to 4 times a day. About. Five days per week to help control his cough and shortness of breath. The medication, per his parent quote, "works pretty well most times". The child is currently feeling well without evidence of acute asthma exacerbation. He is alert oriented, talkative, and able to demonstrate adequate inhaler technique. Peak expiratory flow rate is approximately 60% a predictor.

Which of the following is an appropriate preferred treatment option for this child?

A. Continue current therapy as it is providing adequate symptom control.

B. They begin low dose ICS formoterol therapy, as maintenance and reliever therapy or marked therapy.

C. Begin daily montelukast albuterol as needed.

D. Begin nebulizer budesonide twice daily with nebulizer albuterol as needed.

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YouTube: https://www.youtube.com/watch?v=LwI3U9b81U0&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=158

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