A 1-month-old preterm African American is brought to the emergency department due to lethargy for a day. He is exclusively breastfed. He was in the NICU due to cyanosis but discharged after he became well. The boy is at the 60th percentile for weight and the 70th percentile for height. Head circumference is at the 99th percentile. Physical examination shows a large, bulging anterior fontanel. The eyes appear driven downward and the patient is not able to track upward. No scalp swelling is present. Intracranial hemorrhage is confirmed on head CT scan. Which of the following is the most likely cause of this infant's condition?

Question

A 1-month-old preterm African American is brought to the emergency department due to lethargy for a day. He is exclusively breastfed. He was in the NICU due to cyanosis but discharged after he became well. The boy is at the 60th percentile for weight and the 70th percentile for height. Head circumference is at the 99th percentile. Physical examination shows a large, bulging anterior fontanel.  The eyes appear driven downward and the patient is not able to track upward.  No scalp swelling is present.  Intracranial hemorrhage is confirmed on head CT scan.  Which of the following is the most likely cause of this infant's condition?

Quizplus · Accepted Answer

Eductional Objective: Vitamin K deficiency results in impaired clotting factor carboxylation.  Newborns are at risk for vitamin K deficiency due to poor transplacental transfer of vitamin K and low content in breast milk.  All newborns should receive vitamin K prophylaxis to prevent bleeding complications.

A 1-Month-Old Preterm African American Is Brought to the Emergency