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Short Answer Questions for ED Fellowship Study

Case: Shocked neonate

An 8-day-old infant presents hypotonic, centrally cyanotic and cool peripherally. Peripheral oxygen saturation reads 70% with poor trace. The infant is tachycardic with capillary refill of 5 seconds.

Shocked neonate

1. Give six causes for the shocked neonate. 3 marks

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The baby is centrally cyanosed, a peripheral sats monitor is not showing a good trace but consistently measures SaO2 at 70%. The baby is tachycardic with a CCR of 5 seconds. While you are gaining IV access and organising the team – you get an ECG

2. Describe and interpret the ECG. 3 marks

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You put high flow O2 on via face mask but there is no change in the SaO2 recorded or the baby’s cyanosis. You think the baby likely has a duct dependent lesion.

3. What is the pharmacologic management? 2 marks

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4. For duct-dependent lesions involving the systemic and pulmonary circulations, give two clinical features and two diagnoses for each. 8 marks

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This case forms part of a collaborative marking project designed to support fellowship preparation. In the week leading up to each tutorial, you can contribute answers to any active case. If you contribute, your answers may be reviewed, marked, and used to refine the model answers during the weekly fellowship teaching sessions.

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After the tutorial you can still do the case and self-mark your answers, but your answers will not be included in the group review.