Approach to vomiting (newborn and infant) Quiz: Ace Your Exams
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A 3-week-old girl is brought to the pediatrician by her parents for evaluation of vomiting and diarrhea. Over the past week, the infant has had an increasing frequency of vomiting and diarrhea, and she is now less alert and not feeding well. The infant was born at 39 weeks' gestation to a G1P0 mother. Prenatal course was uncomplicated, and the mother received all recommended prenatal care. Noninvasive prenatal testing (NIPT) performed at 10 weeks' gestation was normal. Weight is at the 12th percentile and the patient has not yet returned to birth weight. Temperature is 36.8°C (98.2°F), pulse is 160/min, respirations are 38/min, and oxygen saturation is 100% on room air. On physical examination, the patient appears fatigued, and she is lying in her parent’s arms. The anterior fontanelle is slightly sunken, and the lips are dry. Cardiopulmonary examination is normal. On genitourinary examination, there is clitoral enlargement, labial fusion, and a urogenital sinus. An in-office glucose level is 42. Which of the following should be ordered next to confirm the most likely diagnosis?
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