skip to main content

Neonatal jaundice — USMLE Step 3 MCQ

Instant feedback + full explanation. One question, done properly.

HardPediatrics (Well-child / Chronic Management)Neonatal jaundiceUSMLE Step 3

A 10-day-old has fever, poor feeding, vesicles on the scalp, focal seizures, and CSF lymphocytic pleocytosis. Maternal genital herpes was not recognized. HSV PCR and bacterial cultures are pending. Which treatment is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Begin intravenous acyclovir during CNS and disseminated HSV evaluation

The best answer is “Begin intravenous acyclovir during CNS and disseminated HSV evaluation”. Vesicles plus seizures and inflammatory CSF strongly suggest neonatal HSV with CNS disease. IV acyclovir begins immediately because maternal lesions are often absent and delay worsens outcome. Oral or topical therapy is inadequate. The alternatives are less suitable because they mistime the intervention, omit a necessary component, or apply treatment for a different physiologic problem; the stem's decisive findings determine the sequence.

Reference: CDC, Genital Herpes Treatment Guideline: https://www.cdc.gov/std/treatment-guidelines/herpes.htm