A 12-day-old infant has vomiting, weight loss and shock. Blood tests show sodium 121 mmol/L, potassium 7.0 mmol/L and glucose 2.1 mmol/L. The

Question

A 12-day-old infant has vomiting, weight loss and shock. Blood tests show sodium 121 mmol/L, potassium 7.0 mmol/L and glucose 2.1 mmol/L. The genitalia are atypical and newborn screening is pending. What is the most appropriate management?

Accepted Answer

Treat adrenal crisis with hydrocortisone, isotonic saline and dextrose

Answer

Give fluid restriction for hyponatraemia

Answer

Wait for karyotype before starting steroids

Answer

Discharge with oral rehydration solution

Answer

Start fludrocortisone alone without glucocorticoid

Congenital adrenal hyperplasia — RACP Paediatrics MCQ

A 12-day-old infant has vomiting, weight loss and shock. Blood tests show sodium 121 mmol/L, potassium 7.0 mmol/L and glucose 2.1 mmol/L. The genitalia are atypical and newborn screening is pending. What is the most appropriate management?