MedBugs: SAQ #275

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Case: Floppy neonate

A 2-week-old male infant is rushed to your ED by his concerned parents. The child is floppy with reduced LOC. He is taken to the resuscitation bay. His parents report he was born at term after an uneventful pregnancy, he was immunised and has been becoming more listless since discharge 10 days ago. Initial observations are as follows:

HR 220/min

CRT 5 seconds

RR 33/min

Disability Responds to pain

Temperature 36.5

IV access is obtained and a venous gas collected: pH 7.07 pCO2 55mmHg pO2 50mmHg HCO3 17 BE -7 Na 120 K 7.2 Cl 90 Lactate 6.26 Glucose 1.6 mmol/L

1. What is the most likely diagnosis and why? 2 marks

2. State your management of three critical issues identified in your initial assessment. 6 marks

3. What is the preferred corticosteroid, its dose and frequency of administration in this child 1 mark

4. Excluding idiopathic and congenital causes, list (3) other aetiologies of this condition 3 marks

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Case: Floppy neonate

1. What is the most likely diagnosis and why? 2 marks

2. State your management of three critical issues identified in your initial assessment. 6 marks

3. What is the preferred corticosteroid, its dose and frequency of administration in this child 1 mark

4. Excluding idiopathic and congenital causes, list (3) other aetiologies of this condition 3 marks

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