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Neonatal sepsis — USMLE Step 2 CK MCQ

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ModeratePediatricsNeonatal sepsisUSMLE Step 2 CK

A 6-week-old Middle Eastern girl comes to the pediatric clinic because of new symptoms noticed by a caregiver. History and focused examination are notable for temperature instability, poor feeding, lethargy, and maternal chorioamnionitis. Temperature is 100.6°F (38.1°C), blood pressure is age appropriate, pulse is 128/min, respirations are 32/min, and oxygen saturation is 96% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Growth parameters, hydration status, and focused testing are consistent with the described pediatric presentation. Which of the following is the most likely cause of this patient's condition?

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Correct answer: A — Host inflammatory response to infection with organ dysfunction

The vignette describes Neonatal sepsis, supported by temperature instability, poor feeding, lethargy, and maternal chorioamnionitis. Host inflammatory response to infection with organ dysfunction is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: https://publications.aap.org/pediatrics#stage-9-order-32