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Neonatal sepsis — MCCQE Part 1 MCQ

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ModerateNeonatal DistressNeonatal sepsisMCCQE Part 1

A 6-day-old newborn is hypothermic, lethargic, feeding poorly, tachypnoeic and has delayed capillary refill. Which of the following is the most appropriate next step?

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Correct answer: DAdmit for full sepsis evaluation and empiric intravenous antibiotics

Admit for full sepsis evaluation and empiric intravenous antibiotics is the single best answer because the age, timing, examination findings and investigations in the vignette fit Neonatal sepsis better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to CPS neonatal sepsis guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: CPS neonatal sepsis guidance