08-23-2010, 07:08 AM
A 25-day-old female newborn is brought to the ED by
her parents. They state that she has not been eating
well this morning and has felt warm. They got a temperature
of 100.2°F with an axillary digital thermometer
at home. They have not noticed any rhinorrhea,
cough, or rashes. The newborn is having 5–6 wet diapers
per day and 5–6 yellow seedy stools per day. She
has not had any sick contacts. She slept normally last
night, but was a little hard to wake up from her morning
nap today. She was the 7.5-lb product of an uncomplicated
term gestation, born via normal
spontaneous vaginal delivery to a GBS negative
mother. There were no complications in the early
neonatal period and she was discharged with the
mother at 2 days of life after receiving routine neonatal
The newborn is seen in her father’s arms. She appears
to have normal color and tone. She is sleeping, but
arouses after some stimulation. She seems fussy, but
can be consoled by her parents. She appears to be wellhydrated,
and has a completely normal physical exam.
Vitals: temperature 38.1°C rectally, pulse 165, respiratory
rate 32.
What further evaluation is indicated now?
A) Complete blood count, blood cultures, catheterized
urine for analysis and culture.
B) Complete blood count, blood cultures, bag urine
for analysis and culture.
C) Complete blood count, blood cultures, chest radiograph,
catheterized urine for analysis and culture.
D) Complete blood count, blood cultures, catheterized
urine for analysis and culture, lumbar puncture
You are awaiting lab results. Should you play
World of Warcraft or start antibiotics? You
decide to start antibiotics. Which antibiotics
are most appropriate for empiric therapy in
this patient?
A) Ampicillin and gentamicin.
B) Ceftriaxone.
C) Valacyclovir.
D) Amoxicillin with or without clavulanate.
E) Any of the above are equally valid choices.
her parents. They state that she has not been eating
well this morning and has felt warm. They got a temperature
of 100.2°F with an axillary digital thermometer
at home. They have not noticed any rhinorrhea,
cough, or rashes. The newborn is having 5–6 wet diapers
per day and 5–6 yellow seedy stools per day. She
has not had any sick contacts. She slept normally last
night, but was a little hard to wake up from her morning
nap today. She was the 7.5-lb product of an uncomplicated
term gestation, born via normal
spontaneous vaginal delivery to a GBS negative
mother. There were no complications in the early
neonatal period and she was discharged with the
mother at 2 days of life after receiving routine neonatal
The newborn is seen in her father’s arms. She appears
to have normal color and tone. She is sleeping, but
arouses after some stimulation. She seems fussy, but
can be consoled by her parents. She appears to be wellhydrated,
and has a completely normal physical exam.
Vitals: temperature 38.1°C rectally, pulse 165, respiratory
rate 32.
What further evaluation is indicated now?
A) Complete blood count, blood cultures, catheterized
urine for analysis and culture.
B) Complete blood count, blood cultures, bag urine
for analysis and culture.
C) Complete blood count, blood cultures, chest radiograph,
catheterized urine for analysis and culture.
D) Complete blood count, blood cultures, catheterized
urine for analysis and culture, lumbar puncture
You are awaiting lab results. Should you play
World of Warcraft or start antibiotics? You
decide to start antibiotics. Which antibiotics
are most appropriate for empiric therapy in
this patient?
A) Ampicillin and gentamicin.
B) Ceftriaxone.
C) Valacyclovir.
D) Amoxicillin with or without clavulanate.
E) Any of the above are equally valid choices.