SAQ 1979 – Unwell neonate with vomiting and electrolyte abnormalities

A one-week-old boy is brought to the ED with one week of vomiting without diarrhoea and poor feeding. He weighs 3 kg, looks lethargic and pale.

Vital signs are temperature 36.9 degrees C, HR 170, capillary refill 5 seconds, RR 40 and SpO2 96% on room air. IV access is obtained and a 20 mL/kg fluid bolus is given.

Bloods: sodium 128, potassium 7.1, chloride 88, bicarbonate 13, urea 11.8, creatinine 80 and glucose 2.2.

List four possible causes of this presentation.

(Marked out of 4.0)

/ 4

State the key blood-test findings.

(Marked out of 4.0)

/ 4

State the most likely diagnosis.

(Marked out of 1.0)

/ 1

State the physical examination finding that would best support the diagnosis.

(Marked out of 1.0)

/ 1

List treatment priorities for estimated 10% dehydration, including medications and doses.

(Marked out of 8.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Treatment priority</th> <th>Medication/dose</th> </tr> </thead> <tbody> <tr> <td></td> <td></td> </tr> <tr> <td></td> <td></td> </tr> <tr> <td></td> <td></td> </tr> <tr> <td></td> <td></td> </tr> </tbody> </table> <p>

/ 8

Total Score: 0 / 18

Percentage: 0%