A four-month-old infant has weight dropping from the fiftieth percentile to the tenth percentile across two visits, with length tracking near the fiftieth percentile. Feeding is exclusive breastfeeding with short feeds and frequent spit-up. Which next step is most appropriate?

A six-month-old has a history of anaphylaxis after a prior dose of a vaccine containing the same component. Which action is most appropriate at today’s visit?

An eight-year-old has daily stool staining in underwear with a history of infrequent large stools. The child denies diarrhea. Exam suggests stool in the rectal vault. Which next step is most appropriate?

A seven-year-old has nasal discharge and a daytime cough for 11 days without improvement. Fever has been absent for the past week. The exam is otherwise reassuring. Which is the best next step?

At a twenty-four-month visit, a toddler screens positive on an autism-specific tool. The family is worried and asks what happens next. Which is the best next step in primary care?

A three-year-old has fever followed by painful oral ulcers and a vesicular rash on the hands and feet. The child is drinking small amounts but refuses solids. Which management is most appropriate?

A fourteen-year-old has mild inflammatory acne on the face with a few pustules and comedones. There are no nodules or scarring. Which initial therapy is most appropriate?

A three-day-old breastfed infant has mild jaundice and has lost eight percent of birth weight. The infant has two wet diapers in the past 24 hours. Which management plan is most appropriate?

A two-year-old has barking cough and stridor only when crying. At rest, there is no stridor and oxygen saturation is ninety-six percent. Which is the best management plan?

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