Rosh Pediatrics Practice Exam

For a well-appearing 4-month-old during an office visit, what is the primary indication for immunoprophylaxis against RSV?

1. APrematurity

2. BRisk baby history

3. CElderly interactions

4. DIndoor crowd exposure

The correct answer is: APrematurity

Immunoprophylaxis against respiratory syncytial virus (RSV) is primarily indicated for infants who are at a high risk of severe RSV disease. Among these risk factors, prematurity is a significant concern. Premature infants are more susceptible to RSV due to their immature respiratory systems and reduced lung function, which can lead to more severe respiratory illness if they contract the virus. For a well-appearing 4-month-old who was born prematurely, the consideration for administering palivizumab, a monoclonal antibody used for RSV prevention, stems from the increased risk associated with their early arrival. Current guidelines recommend that infants born at less than 29 weeks of gestation, or those with specific underlying medical conditions (such as congenital heart disease or would otherwise be in a high-risk group), receive this immunoprophylaxis during RSV season. Other factors like a baby's health history, interactions with the elderly, or exposure to indoor crowds do not carry the same weight in the context of immunoprophylaxis strategy as prematurity does. While general precautions regarding RSV transmission can be taken, the focus remains squarely on those infants whose natural vulnerabilities necessitate this preventive measure, making prematurity the primary indication for immunoprophylaxis