MedBugs: SAQ #529

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Case: Neonatal adrenal crisis

2-week-old male is brought to your Emergency Department by concerned parents. He is floppy and listless and brought into the resus bay. He was born at term after an uneventful pregnancy and received his first immunisations. His parents report progressive lethargy since discharge 10 days ago. Vitals are as follows :

HR 170

CRT 5s

RR 36

AVPU P

Temp 36.5°

VBG: pH 7.07 pCO2 55 HCO3 17 BE -7 Lactate 6.26 Creat 62

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

2. What is the key medication required for this presentation? Provide dose and route. 1 mark

3. In addition to the above, outline your immediate management of (3) critical issues identified in your initial assessment. 6 marks

4. Excluding idiopathic and congenital causes, list (3) other conditions that can result in this type of presentation (adult or paed). 3 marks

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Case: Neonatal adrenal crisis

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

2. What is the key medication required for this presentation? Provide dose and route. 1 mark

3. In addition to the above, outline your immediate management of (3) critical issues identified in your initial assessment. 6 marks

4. Excluding idiopathic and congenital causes, list (3) other conditions that can result in this type of presentation (adult or paed). 3 marks

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