🏥 USMLE Exam Prep

A 3-day-old full-term infant presents for a well-child check. The mother notes yellowing of the skin and sclera. The infant is exclusively breastfed, feeds well, and has adequate wet and soiled diapers. Bilirubin level is 16 mg/dL. Based on the hour-specific nomogram, this level is in the high-risk zone for age. Which of the following is the most appropriate next step in management?

A Reassurance and discharge
B Initiate phototherapy
C Administer intravenous immunoglobulin
D Perform an exchange transfusion

✓ Correct Answer: Option B

For a healthy, full-term infant with a bilirubin level in the high-risk zone for age on the nomogram, phototherapy is the most appropriate initial treatment to reduce bilirubin and prevent kernicterus.

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