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Failure to thrive — USMLE Step 3 MCQ

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ModeratePediatrics (well-child, chronic management)Failure to thriveUSMLE Step 3

A 7-month-old infant has poor weight gain. Formula preparation review shows parents mix one scoop with 4 oz of water to stretch supplies. Examination shows no dysmorphic features or organomegaly. Which of the following is the most likely explanation for this patient's findings?

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Correct answer: C — Inadequate caloric intake from overly dilute formula

Formula dilution decreases caloric density and can cause poor weight gain; careful feeding history is central.

Reference: American Academy of Pediatrics clinical practice guidance and Bright Futures preventive care